Abstract: A system can have an x-ray source that generates a series of individual x-ray pulses for multi-energy imaging. A first x-ray pulse can have a first energy level and a subsequent second x-ray pulse in the series can have a second energy level different from the first energy level. An x-ray imager can receive the x-rays from the x-ray source and can detect the received x-rays for image generation. A generator interface box (GIB) controls the x-ray source to provide the series of individual x-ray pulses and synchronizes detection by the x-ray imager with generation of the individual x-ray pulses. The GIB can control x-ray pulse generation and synchronization to optimize image generation while minimizing unnecessary x-ray irradiation.

Abstract: The disclosure relates to a method for creating a three-dimensional digital subtraction angiography image of a vascular system of a patient. The method includes: providing a first reconstructed three-dimensional filling image which was acquired during at least partial contrast agent filling of the vascular system with a first contrast agent; providing a second reconstructed three-dimensional filling image which was acquired during at least partial contrast agent filling of the vascular system with a second contrast agent; and subtracting the first three-dimensional filling image from the second three-dimensional filling image so that a three-dimensional subtraction angiography image is produced, wherein the first contrast agent and the second contrast agent differ in that one of the two causes increased X-ray absorption and the other causes reduced X-ray absorption relative to a vascular system without contrast agent.

Abstract: A system (300) includes a memory (324) configured to store an inflammation map generator module (328). The system further includes a processor (322) configured to: receive at least one of spectral projection data or spectral volumetric image data, decompose the at least one of spectral projection data or spectral volumetric image data using a two-basis decomposition to generate a set of vectors for each basis represented in the at least one of spectral projection data or spectral volumetric image data, compute a concentration of each basis within a voxel from the set of vectors for each basis, and determine a concentration of at least one of fat or inflammation within the voxel from the concentration of each basis. The system further includes a display configured to display the determined concentration of the at least one of fat or inflammation.

Abstract: The present disclosure relates to a method, an apparatus, and a system for detecting and classifying an ischemic stroke based on a medical image. A medical image based ischemic stroke detecting and type classifying apparatus according to an aspect of the present disclosure includes an acquiring unit which collects images related to a brain of at least one patient; a detecting unit which determines whether the at least one patient is a large vessel occlusion patient, based on the collected image; a determining unit which determines whether a type of the large vessel occlusion is embolism or intracranial atherosclerosis (ICAS), when the at least one patient is a large vessel occlusion patient; and a diagnosing unit which provides treatment direction information which is applied differently according to the determined type of the large vessel occlusion.

Abstract: A computed tomography device includes a holding frame and a ring mount, being movably mounted to the holding frame. The ring mount includes an x-ray detector, with a semiconductor material, operable in an equilibrium of statistical states of occupation. In an embodiment, the computed tomography device includes a first power supply, set up to supply power, in an operating state of the computed tomography device, to a first lot of components of the computed tomography device, the first lot of components being arranged on the ring mount for an image generation process; and a second power supply, separable from the first power supply in terms of circuitry, to supply power to a second lot of components of the computed tomography device in a resting state of the computed tomography device, the components of the second lot being set up to hold the semiconductor material in the equilibrium.

Abstract: Embodiments of the present disclosure provide a flow imaging processing method, which may include determining flow imaging parameters, where the flow imaging parameters include a sound speed for calculation, a center frequency of the transmitting pulse for exciting a probe and a imaging depth; obtaining a velocity measurement range; and determining the first target number of the different transmit angles according to the sound speed for calculation, the center frequency of the transmitting pulse, the imaging depth and the velocity measurement range. The embodiments of the present disclosure also provide an ultrasound imaging device.

Abstract: This invention provides an ultrasonic guidance method of subacromial bursa, which images subacromial bursa easily under ultrasound through specific positioning with patient's another hand appropriately pushing the elbow joint and allow needle insertion through near-end needle insertion from long axis of supraspinatus tendon. Moreover, the bursal fluid can be positional drained by the specific positioning and ultrasonic detector is moved to a sagittal plane around a greater tubercle of humerus for drawing bursal fluid through near-end needle insertion. As a result, in the invention, it is to medially rotate greater tubercle of humerus as possible to prevent lower margin of scapular bone from blocking the imaging of subacromial bursa and to allow SASD bursal fluid pooling near greater tubercle of humerus.

Abstract: Disclosed is an ultrasonic diagnostic apparatus including an improved actuator to compensate for a weight of an input/output device. The ultrasonic diagnostic apparatus includes a main body, an input/output device coupled to the main body and configured to receive information from a user or output information received from the main body, and a connection device to connect the main body and the input/output device, wherein the connection device includes a shaft having a shaft body, a link frame having a frame body and a shaft coupling portion extending from the frame body to be coupled with the shaft, and an actuator including a torsion spring having a first end supported by the shaft and a second end supported by the link frame, so as to compensate for a weight of the input/output device.

Abstract: Method and system for localizing a region of interest in a medium in which cavitation occurs. Method for localizing a region of interest (R) in a medium (M) in which cavitation occurs, the method comprising the steps consisting in: producing cavitation in the region of interest (R), the cavitation generating an acoustic signal, at each of at least three separate positions, detecting a cavitation signal representative of the acoustic signal of the cavitation, for at least two pairs of cavitation signals, determining a delay between the cavitation signals of each pair of cavitation signals, calculating a localization of the region of interest (R) based on the delays and the positions.

Abstract: An ultrasound imaging system includes a transducer array (102) with a plurality of transducer elements (106) configured to transmit an ultrasound signal, receive echo signals produced in response to the ultrasound signal interacting with stationary structure and flowing structure, and generate electrical signals indicative of the echo signals. The system further includes a beamformer (112) configured to process the electrical signals and generate sequences, in time, of beamformed data. The system further includes a filter (118) configured to process the beamformed data, and remove or replace a set of frequency components based on a threshold, producing corrected beamformed data. The system further includes a flow processor (120) configured to estimate a velocity of flowing structure from the corrected beamformed data. The system further includes a rendering engine (224) configured to display the flow velocity estimate on a display (124).

Abstract: A control device acquires a plurality of images including an ultrasound image and a photoacoustic image taken in an examination, selects a first image and a second image to be displayed superimposed on the first image, based on information relating to the examination, and generates an object for outputting at least information for displaying the second image superimposed on the first image to an external device.

Abstract: The present disclosure provides for ultrasound systems and methods to pre-process ultrasound data to distinguish abnormal tissue from normal tissue. An exemplary method can include receiving a set of ultrasound data and partitioning the set into a set of windows. The method can then provide for processing the set of windows to determine a power spectrum for each window. The power spectrum for each window can be processed to determine a normalized power spectrum for each window. This normalized power spectrum can be processed for each window with a machine learning model. The method can then provide for displaying an image where each window of the set of windows is displayed using a unique identifier based on the output of the machine learning model.

Abstract: Embodiments of the present disclosure relate to techniques for neuromodulation delivery. Based on image data acquired from the subject, control parameters controlling energy application of neuromodulating energy may be dynamically changed during the course of the delivery to maintain desired characteristics of the neuromodulating energy. For example, the beam of the neuromodulating energy may be dynamically adjusted to account for movement of an organ during breathing. In another embodiment, a desired region of interest is identified within the subject based on a trained neural network and the acquired image data.

Abstract: Various methods and systems are provided for automatically or semi-automatically adjusting one or more ultrasound imaging parameters for imaging in a second mode based on images obtained in a first mode. In one example, a method includes operating an ultrasound imaging system in a first operating mode, determining an anatomy imaged by the ultrasound imaging system in the first operating mode, and responsive to an operating mode transition request, adjusting imaging parameters of the ultrasound imaging system in a second operating mode based on the first operating mode and the anatomy imaged in the first operating mode.

Abstract: An ultrasound diagnostic apparatus includes: a transmitter; a receiver; a Doppler processor that detects a Doppler shift frequency resulting from a blood flow in a subject, based on a reception signal corresponding to a reflected wave from a sample gate position in the subject; and a velocity scale adjuster that adjusts a velocity scale determining a pulse repetition frequency, based on a Doppler waveform corresponding to the Doppler shift frequency during an observation target period. In a case where a recommendation value of the velocity scale calculated based on the Doppler waveform is larger than a critical value of the velocity scale at which a measurement state calculated based on the sample gate position transitions from a non-high-pulse-repetition-frequency state to a high-pulse-repetition-frequency state, the velocity scale adjuster sets the critical value as the velocity scale to be used in measurement.

Abstract: A system for contactless monitoring of gas levels within an incubator, the system comprising at least one gas sampling line having a proximal end exposed to the internal space of the incubator, and a distal end associated with a monitoring unit for receiving a gas sample obtained from the incubator via the proximal end.

Abstract: A core needle biopsy device including a needle assembly, a cutter drive assembly, a piercer drive assembly and a piercer retraction assembly. The needle assembly includes a piercer and a hollow cutter. The piercer includes a sharp distal tip and a notch proximal to the distal tip. The piercer is slidably disposed within the cutter to sever a tissue sample into the notch. The cutter drive assembly is configured to selectively fire the cutter. The piercer drive assembly is configured to selectively fire the piercer. The piercer retraction assembly is configured to retract the piercer independently of the cutter while the needle assembly is disposed within a patient to expose the notch of the piercer to an exterior of a patient.

Abstract: The embodiments described herein can be used in a variety of sample retrieval, grasping, cutting, and manipulating operations. In some embodiments, an apparatus includes an elongated member and a retention member movably coupled to the elongated member. The elongated member includes a cutting portion configured to cut a target sample when moved, and defines an internal volume within which at least a portion of the target sample can be received. The retention member includes an engagement portion configured to move between a first position and a second position when the retention member is actuated. The engagement portion is configured to extend within the internal volume to exert a force on the target sample within the internal volume when the engagement portion is in the second position.

Abstract: An assembly comprising a drive gear coupled to a shaft and a dial. The drive gear is configured to rotate along a first axis based on movement of the dial. The assembly includes a first linking member located along a second axis and configured to rotate about the second axis based on contact with the drive gear as the drive gear is rotated. The assembly includes a second linking member located along the second axis and configured to rotate about the second axis based on rotation of the drive gear and a coupling between the first linking member and the second linking member. The assembly includes a linking member selector configured to rotate about the first axis and for selecting at least a position corresponding to the first linking member that causes the coupling between the first linking member and the second linking member.

Abstract: A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; a flexible outer ring; an inner ring; a flexible sheath extending between the outer ring and the inner ring; and at least one rigid segment adapted to attach to the flexible outer ring to thereby increase the rigidity of the outer ring. Embodiments of the retractor/protector are described that have interlocking and non-interlocking rigid segments. Embodiments are also described that have bases that insert into or under the flexible outer ring in addition to or in lieu of rigid segments to increase rigidity and/or provide support for a detachable cap.

Abstract: A suture device is utilized in forming a purse string suture during, e.g., laparoscopic end to end anastomosis procedure, to effect joining of two opposing intestinal sections. The suture device is utilized in other procedures such as, e.g., transanal total mesorectal excision (TaTME) for removal of low rectal and ultra-low rectal tumors and preservation of anal sphincters to avoid permanent stomas. In particular, the suture device is utilized in forming surgical stitches used to close an internal anal structure or to narrow a passage for performing further transanal dissection to create total mesorectal excision.

Abstract: A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

Abstract: Compressible adjuncts for use with a staple cartridge are provided. In one exemplary embodiment, a compressible adjunct includes a non-fibrous adjunct material formed of at least one fused bioabsorbable polymer and configured to be releasably retained on a cartridge and configured to be delivered to tissue by deployment of staples in the cartridge. The adjunct material includes a lattice macrostructure having a plurality of drug delivery microstructures formed in the lattice macrostructure, in which each drug delivery microstructure has drug disposed therein. The plurality of drug delivery microstructures are configured to encapsulate the drug to thereby prevent drug release until the plurality of drug delivery microstructures are at least one of thermally ruptured while the adjunct material is stapled to tissue and mechanically ruptured in response to at least one of clamping, stapling, and cutting of the adjunct material. Stapling assemblies for use with a surgical stapler are also provided.

Abstract: A tool assembly includes a cartridge assembly or a heating assembly along with an anvil assembly, and a drive assembly. The drive assembly includes a working member and a laser probe that is pivotally supported on the working member and emits a laser beam. The laser probe is positioned between the cartridge and anvil assemblies such that the laser beam extends across a tissue gap of the tool assembly when the tool assembly is in the clamped position.

Abstract: A surgical instrument system is disclosed which comprises a distal end and a staple cartridge assembly comprising staples removably stored therein. The instrument system further comprises a firing drive including an electric motor and a firing member operably couplable with the electric motor. The electric motor is operable to advance the firing member toward the distal end during a staple firing stroke to eject the staples from the staple cartridge. The electric motor is operable to retract the firing member away from the distal end during a retraction stroke. The surgical instrument system further comprises a manually-operated bailout mechanism operable to perform the retraction stroke in lieu of the electric motor, a controller, and a display in communication with the controller. The controller is configured to display the progress of the retraction stroke when the firing member is being manually retracted by the bailout mechanism.

Abstract: A surgical stapling apparatus includes a loading unit having first and second jaw members, a drive beam, and a firing lockout assembly. The drive beam is axially movable within the loading unit during a firing sequence. The firing sequence includes an advancement stroke which moves the first and second jaw members to an approximated position and a retraction stroke which moves the first and second jaw members to an unapproximated position. The firing lockout assembly includes an iterating plate, a capture gear, and a lockout pin. The iterating plate is disposed adjacent to the drive beam and is incrementally movable proximally within the loading unit during the firing sequence. The capture gear is rotatable between first and second positions during the firing sequence and is configured to move the iterating plate. The lockout pin is configured to lock the drive beam after a pre-determined number of firing sequences.

Abstract: A surgical tool for use with a robotic system that includes a tool drive assembly that is operatively coupled to a control unit of the robotic system that is operable by inputs from an operator and is configured to robotically-generate output motions. A drive system is configured to interface with a corresponding portion of the tool drive assembly for receiving the robotically-generated output motions and applying the output motions to a drive shaft assembly which is configured to apply control motions to a surgical end effector operably coupled thereto. A manually-actuatable control system operably interfaces with the drive shaft assembly to facilitate the selective application of manually-generated control motions to the drive shaft assembly.

Abstract: A method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.

Abstract: Disclosed herein are compositions comprising containers and silk elements. Disclosed herein are methods of regenerating an at least partially severed nerve cell. Disclosed herein are compositions for regenerating an at least partially severed nerve cell.

Abstract: There is provided a laminate membrane for an implant, comprising: an inner layer having an inner layer thickness; a first covering layer disposed on one side of the inner layer, the first covering layer having a first covering layer thickness; and a second covering layer disposed on another side of the inner layer, the second covering layer having a second covering layer thickness.

Abstract: A tubular braided implant is provided including a braid that can be delivered as a single layer braid, invert into itself during deployment to form at least two nested sacks and include additional braid material that can fill the innermost sack. The additional braid material can loop or coil like a ribbon and/or invert to form smaller and smaller nested sacks. The braid can have a variable braid angle along its length such that when positioned for delivery, the can have a high braid angle near its distal end and a low braid angle near the proximal end. In addition, or as a replacement for the braid material that fills the innermost sack, the implant can include an embolic coil that can loop within the innermost sack.

Abstract: A method of providing retrograde perfusion of a patient's brain includes occluding a jugular vein of a subject at a jugular occlusion location, and passively shunting arterial blood from an artery of the subject to a location in the jugular vein distal to the jugular occlusion location.

Abstract: A tourniquet device includes a first jaw having a first tapered tip, and a second jaw having a second tapered tip. The first and second jaws are moveable towards one another to provide a pressure to a member positioned between the jaws. The first tapered tip is offset from the second tapered tip such that the first tapered tip and the second tapered tip are moveable relative to one another in separate planes and the first tapered tip is moveable past the second tapered tip as the first and second jaws are moved towards one another.

Abstract: Cutting guides for use in orthopedic surgery are disclosed. In some embodiments, the cutting guides comprise monolithic polymer cutting blocks with one or more slots and guide inserts to allow for the provision of various desired surgical cuts to a bone by a cutting saw. In other embodiments, the cutting guides may comprise adjustable guide bars with one or more slots and inserts to allow for various desired surgical cuts to a bone. The location and directionality of the cuts may be configured to match the geometry of a surgical implant.

Abstract: A surgical assembly, a stabilisation plate and methods are disclosed. The surgical assembly comprises: a jig (100) comprising a body having a tissue-engaging surface shaped to be received by tissue to be re-orientated by a correction factor, said body defining a plurality of alignment apertures, said plurality of alignment apertures being orientated to be parallel with respect to each other on application of said correction factor. In this way, it is possible to determine from the jig itself when the desired correction factor, rotation or displacement has been applied correctly because the alignment apertures become parallel, thereby avoiding the need for additional operative measurement and/or imaging.

Abstract: A cutting guide for periacetabular osteotomy comprises at least a first main body having a longitudinal opening for the insertion of a cutting instrument, extending from a first end to a second end of the first main body and at least two positioning and fixing arms extending away from the first main body from opposite sides with respect to the longitudinal opening, in order to correctly position the first main body on a bone and fix it thereto through respective fastening members.

Abstract: A dynamic trialing method generally allows a surgeon to perform a preliminary bone resection on the distal femur according to a curved or planar resection profile. With the curved resection profile, the distal-posterior femoral condyles may act as a femoral trial component after the preliminary bone resection. This may eliminate the need for a separate femoral trial component, reducing the cost and complexity of surgery. With the planar resection profile, shims or skid-like inserts that correlate to the distal-posterior condyles of the final insert may be attached to the distal femur after the preliminary bone resection to facilitate intraoperative trialing. The method and related components may also provide the ability of a surgeon to perform iterative intraoperative kinematic analysis and gap balancing, providing the surgeon the ability to perform necessary ligament and/or other soft tissue releases and fine tune the final implant positions based on data acquired during the surgery.

Abstract: A device for drilling into bone includes a luer portion having a luer thread. A bit portion is rigidly coupled to the luer portion, the bit portion configured to be detachably coupled to a bit driver. An adapter portion is rigidly coupled to the bit portion. A drilling portion is rigidly coupled to the adapter portion, the drilling portion comprising a flute configured to create a hole in the bone. A channel extends through the luer portion, the bit portion, the adapter portion, and the drilling portion.

Abstract: Examples of robotically controlled planar cutting systems and methods for controlling cutting systems to prepare bone tissue in surgical procedures, are generally described herein. Applicable surgical procedures for the robotically controlled cutting systems and methods include procedures involving the preparation (e.g., removal, surfacing) of bone tissue, such as is performed in knee arthroplasties. In an example, a robotically controlled planar cutting system can include a housing, a cutting element disposed in the housing, and a cutting control mechanism in communication with a robotic controller to control operation of the cutting element to machine a planar surface. The cutting element can be exposed and retracted relative to the housing and can include a plurality of cutting implements arranged to machine the planar surface.

Abstract: Disclosed herein are rasp adapters, rasp systems, and method of use thereof. The rasp adapter can include a body and a retention element. The body can define a body cavity, a handle opening, and a trunnion bore. The retention element can be located within the body cavity and can include a knuckle and a heal. The knuckle can be located proximate to and movable into and out of the trunnion bore. The heal can be located proximate the handle opening. Movement of the retention element due to a force applied to the heal can cause movement of the retention element and movement of the knuckle into the trunnion bore.

Abstract: A patient-specific guide tool for guiding an object toward a glenoid face of a scapula of a patient for implantation of a shoulder prosthetic device is disclosed. The guide tool includes a guide portion that includes a guide surface. The guide surface is configured to guide movement of the object toward the glenoid face. Furthermore, the guide tool includes a patient-specific portion that is operably coupled to the glenoid portion. The patient-specific portion includes at least one patient-specific surface that is three-dimensionally contoured and that is configured to nest and closely conform to a corresponding surface of the scapula to thereby position the guide surface at a predetermined position relative to the glenoid face.

Abstract: Patient specific implant technology, in which an outline representation of a portion of an outer surface of a periphery of a bone volume is determined and the outline representation is used in operations related to implant matching. In addition, an instrument may be made to match a perimeter shape of a Patient Specific Knee Implant with features for locating holes in a distal femur such that posts or lugs in a femoral implant locate the femoral implant centered medial-laterally within an acceptable degree of precision to prevent overhang of either the side of the femoral implant over the perimeter of the distal femur bone resections. Further, a two-dimensional outline representation may be segmented into segments that correspond to resection cuts used in fitting an implant on a portion of a bone and operations related to implant matching may be performed based on the segments.

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. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.

Abstract: Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.

Abstract: A surgical instrument includes an ultrasonic waveguide extending through a body assembly. An ultrasonic blade connects to the ultrasonic waveguide. A clamp arm assembly of the surgical instrument is able to move from an opened position for receiving a tissue toward a closed position for clamping the tissue. The clamp arm assembly includes a clamp body and a clamp pad facing the ultrasonic blade. A clamp arm actuator of the surgical instrument is able to move from a first position toward a second position to direct the clamp arm assembly from the opened position toward the closed position. A modular coupling of the surgical instrument connects to the clamp pad such that at least the clamp pad can be disconnected relative to the ultrasonic blade for replacement thereof.

Abstract: An end effector assembly includes first and second jaw members movable between an open and closed position to grasp tissue therebetween. First and second proximal flanges extending proximally from the second jaw member and defining a space therebetween, a proximal flange extend proximally from a proximal portion of the first jaw member and define a cam slot. A cam driver operably is coupled to the proximal flange of the first jaw member to define a space between the cam driver and the proximal flange of the first jaw member. A cam bar is disposed within the space defined between the cam driver and the proximal flange of the first jaw member. The cam bar includes a cam pin configured to move within a cam slot of the cam driver to move the first jaw member relative to the second jaw member between the open position and the closed position.

Abstract: A surgical instrument comprising a jaw assembly is disclosed. The surgical instrument further comprises a motor-driven drive system configured to open the jaw assembly. The surgical instrument also comprises a control system configured to control the drive system and, also, control a power supply system configured to supply electrical power to electrodes defined in the outer surface, or outer surfaces, of the jaw assembly. In use, the surgical instrument can be used to apply mechanical energy and electrical energy to the tissue of a patient at the same time, or at different times. In certain embodiments, the user controls when the mechanical and electrical energies are applied. In some embodiments, the control system controls when the mechanical and electrical energies are applied.

Abstract: Apparatus for excising and removing a clip or suture joining leaflets of a native heart valve. The apparatus includes an elongate shaft configured for remote access to a native heart valve, the elongate shaft having a proximal end, a distal end, and a lumen defined therein, and a clamp at the distal end of the elongate shaft, the clamp configured to receive a clip or suture joining native leaflet tissue, the clamp including a passageway extending along a length thereof in communication with the lumen. The apparatus further includes a cutter moveable within the passageway to encompass a clip or suture joining native leaflet tissue received within the clamp and cut native leaflet tissue proximate the clip or suture.

Abstract: Methods for accessing a disc space of a patient as a part of an interbody fusion, as well as the tools employed therewith. An exemplary method may include inserting a leading end of a tool into the patient's back at a location on the posterior surface that is laterally offset from a patient's spinous process and disc. The tool's initial entry into the patient may be from a posterior approach. As the tool is advanced along its designated path, it begins to deviate from the posterior approach towards a lateral approach. When the leading end reaches the disc, it may access the disc from a lateral or substantially lateral location. The tool may be used to access the disc location, to remove disc material, to deliver a cutting tool for removing the disc material, and other steps associated with the spinal interbody fusion procedure.

Abstract: A vibration transmitter can include a straight portion, a curved portion, a first curved surface provided on an external surface of the curved portion, a second curved surface facing a side opposite to the first curved surface and a first portion provided on the first curved surface. The first portion can extend towards a side opposite to the side toward which the curved portion is curved and a distance between the first portion and an imaginary curved surface can increase from the proximal side toward the distal side, and the imaginary curved surface being parallel with the second curved surface.