Abstract: Imaging devices, systems, and methods are provided. Some embodiments of the present disclosure are particularly directed to imaging a region of interest in tissue with photoacoustic and ultrasound modalities. In some embodiments, a medical sensing system includes one or more external optical emitters and a measurement apparatus configured to be placed within a vascular pathway. The measurement apparatus may include a sensor array comprising sensors of two or more types. The sensors may be configured to receive sound waves created by the interaction between emitted optical pulses and tissue, and transmit and receive ultrasound signals. The medical sensing system may also include a processing engine operable to produce images of the region of interest and a display configured to visually display the image of the region of interest.

Abstract: A photoacoustic and ultrasonic endoscope includes an optical fiber, a light diffuser configured to radially diffuse a laser beam transmitted through the optical fiber, and an array transducer having a cylindrical shape and surrounding the light diffuser, the array transducer being configured to transmit the diffused laser beam therethrough and to generate an ultrasonic wave or detect an ultrasonic wave generated by an object to be examined.

Abstract: A probe includes a working channel, at least one optical element provided in the working channel and configured to acquire a spectral image of surface information of an object, and an ultrasonic transducer arranged in the working channel and configured to acquire an ultrasonic image of depth information of the target and move with respect to the at least one optical element.

Abstract: Apparatus, including an insertion tube, configured to be inserted into a body cavity and having a first lumen having a first lumen diameter and a distal opening, and a tubular channel, having a second lumen and an outer channel diameter smaller than the first lumen diameter, inserted into the first lumen. The apparatus includes a support structure, configured to be passed through a space between an inner wall of the insertion tube and an outer wall of the tubular channel to the distal opening in a folded state and to unfold, upon exit of the support structure through the distal opening, in a direction transverse to the first lumen to reach a support dimension that is greater than the first lumen diameter. A plurality of planar two-dimensional arrays of ultrasonic transducers are supported by the support structure, the arrays having transverse dimensions less than the first lumen diameter.

Abstract: An ultrasound signal processor uses an excitation generator to cause displacement of a membrane or surface while a series of ultrasound pulses are applied to the membrane or surface. Phase differences between a transmitted signal and received signal are examined to determine the movement of the membrane or surface in response to the applied excitation. An examination of the phase response of the membrane or surface provides a determination as to whether the fluid type behind the membrane or surface is one of: no fluid, serum fluid, or purulent fluid.

Abstract: According to one embodiment, an ultrasound diagnosis apparatus includes a transmission beam former and a transmitting circuit. The transmission beam former generates a transmission pulse. The transmitting circuit supplies an ultrasound transducer with the transmission pulse received from the transmission beam former as a drive signal. The supply of a clock necessary for the generation of the transmission pulse is stopped during a substantial reception period of echo signals from the ultrasound transducer.

Abstract: A switch circuit connected to a transducer, a reception circuit connected to the switch circuit, a first switch element connected to a reception terminal provided between the switch circuit and the reception circuit, a first resistance element connected to a control terminal of the switch circuit, a second resistance element provided inside the reception circuit, and a second switch element provided inside the reception circuit are provided.

Abstract: A specimen container holding apparatus is disclosed. The apparatus is configured to hold a container for receiving liquids from a bronchoscope. The apparatus includes a needle guide with a first and a second opening configured to receive a needle of the bronchoscope. The first and second opening may be disposed on a removable tip of the needle guide. The removable tip may be detachably connected to a removable tip connection point. The apparatus may further include a slide holder configured to hold a slide.

Abstract: A sample collection device including a collection tube at least partially defining a storage volume therein, a mouthpiece coupled to the collection tube, the mouthpiece defining a channel providing access to the storage volume, and a filter at least partially positioned within the channel, where the filter is configured to filter a sample as it passes through the channel and into the storage volume.

Abstract: Urinary tract infections UTI may be over-diagnosed in very young children because of contamination of a urine specimen by external bacteria when using a conventional catheter. The subject matter disclosed herein relates to a coaxial catheter system and methods for its use, comprising an outer catheter that shields the distal collection opening of an inner catheter during insertion of the system through the meatus. Once the system has been deployed, the distal opening of the inner catheter is exposed in order to collect uncontaminated urine. The system may include a variety of mechanisms to advance the inner catheter relative to the outer, or to retract the outer catheter relative to the inner, a halting mechanism to limit distal movement of the outer catheter, a stopping mechanism to limit distal movement of the inner catheter, and a stabilization mechanism to hold the deployed system in place in male patients.

Abstract: A biopsy gun having a cannula and a stylet guided in the cannula comprises the following a housing, a cannula carriage for moving the cannula, a stylet carriage for moving the stylet, a tensioning grip for tensioning the cannula carriage and the stylet carriage from an initial position into a tensioning position, and an engaging member that is provided on the tensioning grip and has recesses adapted to engage with corresponding projections of the cannula carriage and the stylet carriage. The engaging member is rotatably attached to the tensioning grip and is biased by a spring against a contact surface of the housing.

Abstract: A surgical instrument retainer can include a proximal component and a distal component. The proximal component can include a head, a first body, and a proximal plurality of projections. The distal component can define a second instrument bore and a body bore and can include a distal plurality of projections. The can head engageable with the end effector coupler to position the instrument retainer within the end effector coupler.

Abstract: A dilation system for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a wedge assembly and an actuating mechanism. The wedge assembly comprises includes a base and a plurality of blades extending from the base so that the distal end of the blades extend away from the base. The mechanism is operably associated with the blades so as to cause the distal end of the blades to move from a closed condition to an expanded condition.

Abstract: A method for assessing a joint includes inserting a joint distraction lever into a space between a first bone and a second bone of the joint, distracting the joint with the joint distraction lever, determining, using a measurement device of the joint distraction lever, a distraction force applied by the joint distraction lever as the joint distraction lever is used to distract the joint, determining whether the distraction force matches a predetermined amount of the distraction force, and in response to determining that the distraction force matches the predetermined amount of the distraction force, capturing first poses of the first bone and the second bone.

Abstract: The present invention provides fastener anchoring devices with protruding fasteners releasably attached to graspers for insertion into a target site such as soft tissue. The devices include a retaining mechanism that can be actuated to release the fasteners from the grasper. The devices can include support material preloaded onto the fasteners.

Abstract: A device for cardiac surgery is disclosed, having a) a plurality of pairs of suture guides spaced about the frame; b) a plurality of suture tubes, with one suture tube corresponding to each pair of suture guides; c) a plurality of snares, each corresponding to and passed through one of the plurality of suture tubes so that a handle at one end of the snare protrudes from a proximal end of the corresponding suture tube and a snare loop at another end of the snare protrudes through a distal end of the corresponding suture tube, and wherein the snare loop further protrudes through one of the suture guides in the corresponding pair of suture guides; and d) a plurality of sutures, each corresponding to one of the pairs of suture guides and coupled to the suture guide in the corresponding pair of suture guides which does not have the snare loop passing through it.

Abstract: An exemplary surgical device includes a handle including a bore, and a trigger configured to advance or retract a needle through the bore of the handle. The trigger is configured to rotate about a pivot axis and is further configured to slide in distal and proximal directions. The device may be operated using one hand, and permits a user, such as a surgeon, to advance a needle through the device using intuitive, relatively easy thumb movements. While the device may be used in other techniques, it is particularly useful in meniscal repairs, including inside-out meniscal repairs.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: A compound barb medical device is provided which includes an elongated body having at least one barb formed along the length of the body, the barb defining an inner surface with a first portion disposed at a first orientation relative to a longitudinal axis of the elongated body, and a second portion disposed at a second orientation relative to the longitudinal axis. Optionally, the barb defines a third portion disposed at a third orientation relative to the longitudinal axis. A method for forming a compound barb on a medical device is also provided.

Abstract: A surgical instrument comprising a sensing system is disclosed.

Abstract: Surgical instruments with axially movable firing members that are driven by a series of drive components that are loosely linked to each other when traversing an articulation joint of the surgical instrument. The drive components are configured to serially engage a rotary drive member located distal to the articulation joint such that the rotary drive member causes the drive components to form an axially rigid series of said drive components configured to apply an axial drive motion to the firing member.

Abstract: A surgical device including a handle assembly, an elongated portion, and outer band assembly, and inner band assembly, a trocar assembly, and a seal assembly is disclosed. At least a portion of the outer band assembly is disposed radially within the outer sleeve. At least a portion of the trocar assembly is disposed radially within the inner band assembly. The seal assembly includes a first annular seal and a second annular seal. The first annular seal is disposed radially inward of the outer sleeve and radially outward of the outer band assembly. The second annular seal is disposed radially inward of the outer band assembly and radially outward of the inner band assembly.

Abstract: An adapter for releasably connecting a loading unit to a handle assembly includes a proximal drive shaft, a distal drive shaft, and a shear pin connecting the proximal drive shaft to the distal drive shaft. The proximal drive shaft includes proximal and distal portions. The proximal portion of the proximal drive shaft is configured for releasable connection to the handle assembly. The distal drive shaft includes proximal and distal portions. The distal portion of the distal drive shaft being configured for releasable connection to the loading unit. The shear pin is configured to rotationally fix the proximal drive shaft to the distal drive shaft and is configured to fracture to permit rotation of the proximal drive shaft independent of rotation of the distal drive shaft when a predetermined torque is applied to the distal drive shaft.

Abstract: A method is provided for applying an adjunct element to a surgical stapler end effector having first and second stapling surfaces using an applicator. The method includes providing the end effector in an open state in which the first and second stapling surfaces are spaced apart. With the end effector in the open state, at least a portion of the applicator is positioned between the first and second stapling surfaces. Without engaging a closure system input feature of the surgical stapler, a portion of the end effector is compressively engaged by the applicator to thereby secure the adjunct element to one of the first or second stapling surfaces. The applicator and the end effector are withdrawn relatively away from one another so that the adjunct element remains attached to the one of the first or second stapling surfaces of the end effector.

Abstract: A surgical fastening instrument includes an elongate shaft extending from a handle. An end effector is coupled to one end of the elongate shaft. The end effector has a first jaw with retainer strips disposed thereon. Each retainer strip includes rows of receptacles and each receptacle has a passageway leading to a chamber formed in the first jaw. The end effector also includes a second jaw with fastener strips disposed thereon. The first jaw is pivotally coupled to the second jaw. Each fastener strip includes rows of fasteners and each fastener is slidably positioned on a lance extending from a surface of the second jaw. The lances are aligned with the receptacles and each fastener has barbs configured to be retained in one of the chambers.

Abstract: A tissue approximation device for wound closure having a first arm having a proximal end and a distal end, a second arm having a proximal end and a distal end, the second arm connected to the first arm. A first rake member is connected to the distal end of the first arm and has a first plurality of tissue engaging members extending therefrom to engage tissue. A second rake member is attached to the distal end of the second arm, the second rake member having a second plurality of tissue engaging members extending therefrom to engage tissue. A transverse bar can extend through the first and second rake members such that the first and second rake members movable along the transverse bar. Systems and methods for wound closure are also disclosed.

Abstract: Some systems and methods for operating a vessel occlusion catheter may include a control and inflation device to control the filling of the balloon in such a manner that the vessel wall will not be overstressed while the safe occlusion of the blood vessel is achieved.

Abstract: Surgical clips and surgical applicators used in performing rapid tissue closure in either minimally invasive surgeries or traditional open procedures are provided. In one example approach, a surgical clip comprises opposing sides extending from a top portion and terminating at tips positioned below the top portion. The resting position of the clip is its closed position. Edges of the top portion and the opposing sides form opposing faces perpendicular to the opposing sides. The opposing faces are angled inwardly towards each other at a region of the faces adjacent to the top portion. Grooves are formed in each of the opposing sides. The grooves are configured to engage inwardly turned tracks of a clip applicator such that, when a force is applied to the clip, the opposing sides bend outwardly away from each other to place the clip in an intermediate open position.

Abstract: A hand tool has a pivot connection pivotally attaching a first arm to a second arm, with the pivot connection fixed relative to the first arm and movable to first and second positions relative to the second arm. A spring urges the pivot connection into the first position. When jaws on the front ends of the arms clamp tissue with force greater than a pre-set threshold, the spring force is overcome and the jaws may move linearly apart, allowing for more uniform clamping of the tissue. The first arm may have an arm spring extending between a front segment pivotally attached to a rear segment of the first arm.

Abstract: In at least one embodiment, a medical device can comprise an elongate outer sheath that extends along a sheath longitudinal axis and defines a central lumen extending therethrough, the elongate outer sheath can comprise a proximal sheath portion and a distal sheath portion. A first guidewire can comprise a first guidewire end and a second guidewire end, the first guidewire can extend from the first and second guidewire ends through the central lumen and can form a distal looped portion. An occlusion device can be disposed at a distal end of an elongate flexible shaft. The elongate flexible shaft can extend from the proximal sheath portion through the central lumen. The occlusion device can include a guide lumen through which the first guide wire passes.

Abstract: Disclosed are radially expanding debridement tools configured to pass through an access channel present in a first tissue of a living being, expand radially, and create a void in a second tissue of the living being upon being advanced distally through the access channel and into the second tissue while being rotated, wherein the shape of the void comprises at least one step. Further disclosed are debridement systems and methods of treating tissue defects in living beings.

Abstract: A surgical instrument including an articulating region. An outer tube and an inner tube are axially fixed to one another distal to the articulating region and axially movable relative to one another proximal to the articulating region. Relative movement of the inner and outer tubes provides for articulation of the articulating tube assembly to a curved configuration. A working tool may be removably directed through a central cannula defined by the inner tube. The working tool may include a shaft having a flexible region configured to be arranged within the articulating region. The shaft may rotate within the inner tube with the articulating tube assembly in the curved configuration. The working tool may include a housing hub configured to be coupled with a handle to removably position the flexible region within the articulating region. Multiple working tools may be interchangeably directed through the central cannula.

Abstract: A method to guide in preparation of a bone relies on an instrument having a shaft with a working end and a stop member. The shaft is free to translate along an axis. Surgical planning data is registered to the bone to determine intra-operative coordinates of the desired axis and depth. The instrument holder is positioned by the bone so the stop member contacts the instrument holder to prevent translating beyond the desired depth. Alternatively, an arm is manipulated to align the instrument with the desired axis. The working end rests on the bone to define a linear separation to the desired depth. By proximally translating the instrument holder to contact the stop member and distally translating the instrument holder along the shaft, the stop member physically stops translating beyond the desired depth. A surgical system for performing the methods is provided; a reamer or impactor are also disclosed.

Abstract: A system and method for attaching tissue to bone are provided. In one embodiment, a system for attaching tissue to bone includes a suture, suture anchor, inserter tool, drill, and drill guide having an outer guide and an inner guide. A method for attaching tissue to bone includes attaching a suture to tissue, nesting the suture in a notch on the distal end of the outer guide, passing the suture through a lumen formed in the outer guide, and inserting an inner guide in a lumen formed in the outer guide. The drill guide protects the suture from rotational movement of the drill and allows a user to maintain alignment between the drill guide and the drilled hole. As a result, a suture anchor can be more easily positioned within the drilled hole.

Abstract: An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

Abstract: An apparatus (20) includes a tube (22), configured to advance to a blockage, and including a proximal hub (24) configured to connect to a suction-applying device such that, following the advancement of the tube to the blockage, a suction force generated by the suction-applying device is applied, via the tube, to the blockage, a shaft (26), including first and second electrically-conductive circumferential portions (28, 30), configured to pass through the tube, and first and second electrically-conductive elements (34, 38), configured to connect the first and second electrically-conductive circumferential portions to respective terminals of a power source (36).

Abstract: Devices and methods for articulating a distal end of a surgical device are provided. In one exemplary embodiment, the device includes an articulation joint that includes both an inner guide and an outer sleeve. The inner guide includes one channel extending therethrough that receives both a cutting mechanism and a closure band. Further, an outer surface of the inner guide, in conjunction with the outer sleeve, can define two additional channels that each receive an articulation band for articulating an end effector coupled to the articulation joint. The outer surface of the inner guide can include a plurality of ribs that also help define the two additional channels. Further, the outer sleeve can include a plurality of slots formed in it to improve flexibility and stability. Additional configurations of articulation joints, and configurations of components of a surgical device, are also provided, as are methods for using the same.

Abstract: This application is directed to a medical instrument with a hollow shaft, an actuating unit at the proximal end and an instrument tip with an instrument at the distal end, the instrument actuated via an actuating element, the element being in connection with the actuating unit and the instrument tip being pivotable relative to the shaft via a joint mechanism; the joint mechanism having pivoting members with proximal-side drive via steering wires such that movement of the proximal-side drive causes movement of the distal-side pivoting members and pivoting of the instrument tip; and a trigger mechanism with which the steering wires can be brought into a relaxed state that releases the articulation of the instrument tip. In order for the medical instrument to be cleaned and ensure that the medical instrument is safely removed even if the proximal-side drive fails, the trigger mechanism is a purely mechanical trigger mechanism.

Abstract: A forceps includes an end effector assembly including first and second jaw members, a blade, a lever member operably coupled to the end effector, a trigger member operably coupled to the blade and defining an actuation path therealong. A trigger safety member is pivotably coupled to the lever member such that, when the lever member is disposed in an initial position, the trigger safety member is disposed in a position blocking the trigger member. When the lever member is disposed in a compressed position, the trigger safety member is disposed in a position, wherein the trigger safety member is displaced from the actuation path to permit movement of the trigger member, wherein the safety member rotates relative to the lever member as a function of movement of the lever member to block/unblock the trigger member.

Abstract: A surgical end effector assembly includes first and second jaw members configured to grasp tissue. At least one of the jaw members defines a channel. A cutting element reciprocates through the channel to cut grasped tissue. The cutting element may include a first bevel defined along a first portion of a distal edge on a first side surface of the cutting element and a second bevel defined along a second portion of the distal edge on a second side surface of the cutting element. The first and second portions of the distal edge are sharpened to facilitate cutting tissue upon distal advancement of the cutting element. Alternatively or additionally, the cutting element may include a proximal body and a distal fin defining a height greater than a height of the proximal body and including a thinned portion defining a depression within a first side surface thereof.

Abstract: A surgical cutting and fastening instrument is disclosed. According to various embodiments, the instrument includes an end effector comprising an elongate channel, a clamping member pivotably connected to the channel, and a moveable cutting instrument for traversing the channel to cut an object clamped in the end effector by the clamping member when the clamping member is in a clamped position. The instrument may also comprise a main drive shaft assembly for actuating the cutting instrument in the end effector, a gear drive train connected to the main drive shaft assembly, and a motor for actuating the gear drive train. The instrument may also includes a closure trigger and a firing trigger, separate from the closure trigger, for actuating the motor when the firing trigger is retracted. Also, the instrument may comprise a mechanical closure system connected to the closure trigger and to the clamping member for causing the clamping member to pivot to the clamped position when the closure trigger is retracted.

Abstract: A device for endovascular treatment to ameliorate aneurysm recurrences by deploying a treatment mesh having a plurality of vertically oriented elongated support reinforcement elements that are substantially parallel and oriented upon a plane in communication with the mesh. Upon deployment, the array of distal ends of the support extensions and reinforcements are substantially oriented upon a plane, which plane is in substantially the same orientation as the opening of the aneurysm into which the device was deployed. The treatment mesh may incorporate a coating of hydrogel, optionally impregnated with pharmaceutical compounds.

Abstract: A system and method for reducing the risk of contamination of interior regions of a needle guide which is disposed on an endocavity transducer, which system includes an elastic membrane forming a pocket which covers a needle exit hole in the needle guide. The pocket is disposed on a sheath which is both; disposed around the endocavity transducer and between the endocavity transducer and the needle guide.

Abstract: A catheter assembly may include a cannula. The cannula may include a distal tip, an elongated tubular shaft, and an inner lumen formed by the elongated tubular shaft. A first portion of the elongated tubular shaft may have a first outer diameter. The first portion may be proximate the distal tip. A second portion of the elongated tubular shaft may have a second outer diameter. The second outer diameter may be greater than the first outer diameter. The catheter assembly may also include a catheter adapter, which may include a catheter and a catheter hub. The second portion of the elongated tubular shaft may be at least partially disposed in the catheter hub.

Abstract: A tissue containment system includes a bag body, a member extending from the bag body and defining a channel, and a viewing window. The bag body at least partially defines an interior region configured to contain a loose tissue specimen and defines an opening sized to receive the loose tissue specimen. The bag body is configured such that a first portion of the bag body can be disposed in an abdominal cavity of a patient while a second portion of the bag body extends outside of the patient. The viewing window is at least partially transparent and provides a seal between the interior region of the bag body and an ambient environment. The channel of the member is configured to receive a tissue visualization device that can be used to view the interior region of the containment bag through the viewing window.

Abstract: Methods, systems, and compositions are provided for implanting an implantable device into a biological tissue (e.g., muscle, brain). A subject implantable device includes: (i) a biocompatible substrate, (ii) a conduit (e.g., an electrode, a waveguide) that is disposed on the biocompatible substrate, and (iii) an engagement feature (e.g., a loop) for reversible engagement with an insertion needle. The biocompatible substrate can be flexible (e.g., can include polyimide). The implantable device is implanted using an insertion needle that includes an engagement feature corresponding to the engagement feature of the implantable device. To implant, an implantable device is reversibly engaged with an insertion needle, the device-loaded insertion needle is inserted into a biological tissue (e.g., to a desired depth), and the insertion needle is retracted, thereby disengaging the implantable device from the insertion needle and allowing the implantable device to remain implanted in the biological tissue.

Abstract: A trocar assembly for releasable engagement with an adapter assembly of a surgical stapling instrument includes a trocar mechanism that includes a trocar member that is at least one of rotatable or articulable relative to a housing of the trocar assembly.

Abstract: Device and method for implantation of hair grafts into the scalp of a patient. In the device, a cross-sectional shape of a rod riding in an implantation needle is configured with respect to the needle to communicate a vacuum in a chamber anterior to the needle forward to an interior of the needle, thereby facilitating loading of the hair graft into the device by direct-to-needle aspiration of the hair graft.

Abstract: A lead extraction tool includes a lever for enhanced mechanical advantage. A belt of the tool which causes rotation of a cutter on an end of a sheath can be driven both when a trigger of the handheld tool is squeezed and when the trigger is relaxed. A pair of winged engagers are carried upon a pedestal which moves with the trigger, with a driver coupled to a portion of the trigger causing a rear winged engager or a front winged engager to engage the belt, both when squeezing the trigger and when relaxing the trigger.

Abstract: A pair of cooperating catheters are used together to provide rapid access to the Left heart for diagnostic or therapeutic interventions. The initial entry point for the catheter pair is the groin. The pair of catheters can be used to carry out an electrographic determination of the location of the Fossa Ovalis on the septum. Features on the Catheter system permit quick and reliable confirmation of the catheter location via echo or x-rays. Once across the septum the inner catheter is removed from the outer catheter and a standard intervention may be carried out through the lumen of the outer catheter.