Abstract: A bone anchor, including: a bone engaging member including: a first proximal bone engaging portion and a second distal bone engaging portion; and an expansion feature configured to allow radial expansion of the first bone engaging portion and the second bone engaging portion; an expander having a first proximal expansion portion and a second distal expansion portion and displaceable between a first position relative to the bone engaging member and a second position relative to the bone engaging member; a tissue capture feature; and wherein the first expansion portion of the expander is configured to expand the first bone engaging portion of the bone engaging member and the second expansion portion of the expander is configured to expand the second bone engaging portion of the bone engaging member when the expander is in the second position.

Abstract: An anatomical tissue anchor includes a central body and tissue stabilizing arms extending outwardly from the central body. The tissue stabilizing arms are spaced apart from one another. The tissue anchor has a deployed state in which the central body defines an opening configured to allow an instrument to be passed therethrough and the tissue stabilizing arms extend radially outwardly from the central body.

Abstract: An apparatus for laparoscopic intracorporeal knot tying includes a needle grasper including a needle holder shaft and a needle holder jaw located at a distal end of the needle holder shaft, and a knot loop grasper including a knot loop holder shaft, which is slidable on the needle holder shaft, and a knot loop holder jaw located at a distal end of the knot loop holder shaft. In an inactive state of the apparatus, the knot loop holder is located proximal to the needle holder jaw. In an active state of the apparatus at a time of a knot tying, the knot loop holder jaw slides on the needle holder shaft toward the distal end of the needle holder shaft and beyond the needle holder jaw to carry components of a knot over a standing end of a suture held by the needle holder jaw.

Abstract: A device for repair meniscus tears utilizing transfer cannulas that are pulled or kedged through the meniscus tear by a pulling element. The transfer cannulas are positioned via sliding guide to prevent a shear force acting on the meniscus.

Abstract: Various exemplary methods, systems, and devices for surgical suturing are provided. In general, a loading element can be configured to facilitate loading of a plate into a surgical instrument configured to facilitate passage of a suture through tissue. The surgical instrument can be configured to advance the suture through a tissue of a patient, to capture a free end or looped end of the suture after the suture's advancement through the tissue, and to pull the captured suture out of the patient's body with a portion of the suture remaining passed through the tissue within the patient's body.

Abstract: A method of suturing includes: (1) wrapping a first segment of a suture through a traction loop; (2) pulling the traction loop and the first segment through an opening in a suture lock; (3) continuing to pull the traction loop such that a second segment of the suture extends through the opening, wherein the second segment has a greater denier than the first segment such that the second segment more nearly fills an entire dimension of the opening than the first segment; and (4) locking the suture in place with the second segment in the opening.

Abstract: A port closure device includes a pair of jaws that may move repeatably between open and closed positions and repeatably pass a needle therebetween. The jaws are generally perpendicular to a longitudinal axis of the device in the closed position and generally parallel to the longitudinal axis in the open position. The device further includes a jaw control rod for controlling movement of the jaws and a needle control rod for controlling the passing of the needle between the two jaws.

Abstract: Systems include an end effector having a first jaw and a second jaw, a motor system configured to actuate the end effector, and a processor. The processor is configured to determine a maximum tip deflection for the end effector, determine a torque limit based on the maximum tip deflection, and operate, subject to the torque limit, the end effector using the motor system. In some embodiments, the maximum tip deflection is determined based a type of staple cartridge being used by the end effector. In some embodiments, the type of staple cartridge identifies a length of staples fired by the end effector. In some embodiments, the firing of the staples is stalled when an applied torque exceeds the torque limit. In some embodiments, the processor is further configured to fire staples subject to the torque limit.

Abstract: A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

Abstract: A system is configured to bring about anastomosis between two lumens in a patient or between two sections of a single lumen in a patient. The anastomosis system includes a first tissue-compressing element, a second tissue-compressing element, and an energy source. The energy source can be a thermal energy source or laser energy source. Tissue is interposed between the elements. Magnetic material incorporated into the tissue-compressing elements facilitates the alignment of the elements as well as compression of the interposed tissue. The energy source can deliver energy to tissue. This delivery of energy can cause local changes to the tissue that can help maintain positional stability of the implants, can bring about immediate patency of the anastomosis and can otherwise facilitate achieving desired outcomes for the patient.

Abstract: A method is provided for operating a powered surgical stapler having a motor unit, a controller. and a stapling assembly having a closure member, a staple driver member, and a knife member. The controller receives a user input that indicates a tissue gap to be defined by the stapling assembly in a closed state. Based on the user input, the controller controls the motor unit to actuate the closure member to transition the stapling assembly to the closed state to define the tissue gap and clamp tissue therein. The controller then controls the motor unit to actuate the staple driver member to drive staples into the clamped tissue. In response to determining that the staple driver member has reached a predetermined longitudinal position, the controller controls the motor unit to initiate actuation of the knife member to cut the clamped tissue.

Abstract: A device for occlusion of a body lumen including an implantable occlusion apparatus (3) operably attached to an elongated catheter member (4) configured for transluminal delivery and deployment of the occlusion apparatus in the body lumen. The occlusion apparatus includes a radially expansible element (5) detachably attached to the elongated catheter member, and adjustable between a contracted orientation for transluminal delivery and a deployed orientation configured to occlude the body lumen, an energy delivery element (6, 14, 21) configured to deliver energy to surrounding tissue to heat the tissue, and a sensor (7) configured to detect a parameter of the wall of the body lumen. The energy delivery element (6, 14, 21) and sensor (7) are axially movable independently of the radially expansible element whereby, in use, the energy delivery element and sensor can be transluminally retracted leaving the radially expansible element in-situ occluding the body lumen.

Abstract: A device for retarding birth including an upper ring for surrounding a cervix, an anchoring component for anchoring the device, and an elastic component for attaching the upper ring to the anchoring component, wherein the elastic component pushes the upper ring and the anchoring component apart. A device for retarding birth including a sleeve for surrounding a cervix along a greater portion of a length of the cervix, a support strip on the sleeve directed along an axis of the sleeve, and a ring at least partially around the sleeve, in which when a top of the sleeve is pushed to expand radially, the support strip pivots on the ring, such that an end of the support strip near the top of the sleeve moves radially outward, and an end of the support strip near the bottom of the sleeve moves radially inward. Related apparatus and methods are also described.

Abstract: An LAA exclusion system includes a clip comprising first and second separate clip struts, and a bias device comprising spring portions, and a delivery device having clip-contacting ends. The first clip strut has a first proximal end. The second clip strut has a second proximal end adjacent the first proximal end. The clip struts together define a first exterior surface and an opposing second exterior surface. The first spring portion connects the first clip strut to the second clip strut along the first exterior surface and the second spring portion connects the first clip strut to the second clip strut along the second exterior surface. The spring portions define therebetween a strut-securing area at the first and second proximal ends. The clip-contacting ends are configured to removably connect to the proximal ends of the clip struts through the strut-securing area.

Abstract: Tools and methods for expanding a precursor hole in a host material to receive a fixture. The precursor hole is enlarged by a rotary tool having helical flutes and interposed lands. The flutes have a negative rake angle. The lands each have a working edge that cuts the host material when the tool is rotated in a cutting direction, and that condenses the host material when the tool is rotated in a densifying direction. The body of the rotary tool has a stopper section that plugs the hole when a certain depth is reached. When the tool is used with a copious wash of irrigating fluid at or below the necessary depth, hydraulic pressure builds inside the precursor hole. The hydraulic pressure can be advantageously exploited in cutting mode to autograft a slurry of host material particles into the sidewalls of the hole and create an incipient densifying crust.

Abstract: Drill assemblies and methods for drilling into bone are provided. In general, a drill assembly can have a flexible distal portion configured to move between a substantially straight configuration, in which a longitudinal axis of the distal portion is aligned with a longitudinal axis of a proximal shaft portion of the drill assembly, and a curved configuration, in which the longitudinal axis of the distal portion is angularly offset from the longitudinal axis of the plurality of segments located between the proximal shaft and the drill tip. The drill assembly can include a connecting element extending from the proximal shaft, through the segments, and to the drill tip at a distal end of the drill assembly. The drill assembly can include a conformal covering on the distal portion thereof that is configured to curve.

Abstract: A flexible auger design for low-torque transmitting drive shafts, which allows effective tissue material transport through curved, flexible tubes and channels. A hollow auger has a hollow center, so that the helical member hugs the inner wall of the tube and material is transported along the center axis and the inner wall of the tube. The hollow flexible auger allows for transportation of material from an operative location in the patient (material removal) as well as to operative location in the patient (material delivery).

Abstract: A method for inserting an interspinous spinal implant into an opened gap between first and second spinous processes of adjacent superior and inferior vertebras, respectively includes the following. First forming an opened gap between a first spinous processes of a superior vertebra and a second spinous processes of an adjacent inferior vertebra by first inserting a decompression knife into diseased areas of the adjacent superior and inferior vertebras, then cutting fascia tissue, then separating soft tissue from bone by rocking the decompression knife back and forth, and then inserting a broach cutter into the diseased areas of the adjacent superior and inferior vertebras and cutting interspinous ligament between the adjacent superior and inferior vertebras. Next, determining and selecting an appropriate sized and shaped interspinous spinal implant for the opened gap by inserting a sizing tool into the opened gap, and sizing the opened gap with the sizing tool.

Abstract: A wedge osteotomy method inserts a first wire into a first bone of the foot, distal from tissue to be removed. A second wire is inserted into a second bone, so the tissue to be removed is distal from the second wire. A cut guide is pivoted about the first wire, until a first axis of the cut guide is parallel with a longitudinal axis of the first metatarsal. The cut guide has a slot perpendicular to the first axis for guiding a cutter to cut bone, while the first axis is aligned with the longitudinal axis of the first metatarsal. The cut guide is then pivoted about the second wire, until the first axis is aligned with the longitudinal axis of the talus, and bone is cut through the slot, to form a second planar cut into or through bone material.

Abstract: Surgical drill guides having a guide shaft and a set of distal guide teeth extending from the guide shaft. The guide shaft has proximal and distal portions having two distinct inner and outer diameters, with a tapered zone extending between the two portions. Wall thickness is maintained or increased from the proximal portion to the distal portion of the shaft, reinforcing the rigidity of both the shaft and the distal guide teeth.

Abstract: A clot retrieval device for removing an occlusive clot from a blood vessel. The device includes a clot engagement section having a constrained delivery configuration and an expanded deployed configuration, wherein in the expanded deployed configuration. The clot engagement section can include a plurality of peak sections configured to vary contact pressure between the clot and the device along a length of the device; and a plurality of troughs between respective peak sections comprising a clot reception space. Each peak is configured to exert a relatively high compressive force on the clot whereas each trough is configured to exert little or no compressive force on the clot.

Abstract: Provided is an end tool including: a first jaw configured to rotate independently; a J11 pulley coupled with the first jaw and configured to rotate around a first axis formed at an end tool hub; a J16 pulley formed at one side of the J11 pulley and configured to rotate around a second axis formed at one side of the first axis; a J12 pulley and a J14 pulley formed at one side of the J16 pulley, and configured to rotate around a third axis formed at a predetermined angle with the first axis. The end tool may further include: a first jaw wire configured to at least partially contact the J12 pulley, the J11 pulley, the J16 pulley, and the J14 pulley; a J16 pulley formed between the J11 pulley and a J12 pulley/a J14 pulley; and the first jaw wire is located on an internal tangent of the J11 pulley and the J16 pulley.

Abstract: A surgical system includes a surgical instrument, a collection canister, outflow tubing coupled between the surgical instrument and the collection canister to define an outflow path from the surgical instrument to the collection canister, and a control console. The outflow tubing includes a valve module including a controllable valve disposed within the outflow path to selectively control flow therealong. The control console is configured to control operation of the surgical instrument and to control the controllable valve.

Abstract: Provided herein is a catheter assembly including, in some embodiments, a core wire configured for linear actuation and a damping mechanism around the core wire. The core wire includes a proximal end with a sonic connector configured to couple to an ultrasound-producing mechanism. The core wire includes a distal end configured to modify intravascular lesions with vibrational energy from the ultrasound-producing mechanism. The damping mechanism includes a gasket system and a retainer to retain the gasket system in a damping-mechanism bore of the catheter assembly. The damping mechanism is around a proximal-end portion of the core wire, where the damping system can provide a compressive force sufficient to dampen transverse wave-producing vibrational energy in the proximal-end portion of the core wire without restricting the linear actuation of the core wire through the damping mechanism including extension and retraction of the core wire through the damping mechanism.

Abstract: An ultrasonic surgical tool system for actuating a handpiece with a tip. The frequency of the drive signal applied to the handpiece drivers is a function of the equivalent of current through the mechanical components of the handpiece and tip and the frequency responsiveness of these components.

Abstract: A surgical instrument includes an end effector, a shaft assembly proximally extending from the end effector, and at least one translatable rack gear assembly coupled with the shaft assembly. The shaft assembly includes at least one elongate member connected to a select one or both of the end effector and the shaft assembly. The at least one translatable rack gear assembly includes a rack gear, an anchor longitudinally adjustable relative to the rack gear, and an insert received within the anchor. The anchor is coupled with the at least one elongate member such that adjustment of the anchor relative to the rack gear longitudinally moves the insert and the at least one elongate member for adjusting tension of the at least one elongate member.

Abstract: A surgical device includes an outer member, an inner member, and at least one locking element. The inner member is at least partially supported within the outer member. The at least one locking element is configured in a first arrangement of the surgical device to lock the inner member in a first position and configured in a second arrangement of the surgical device to unlock the inner member from the first position. The at least one locking element is configured to change from the first arrangement to the second arrangement upon coupling the inner member in an operational arrangement to a hand piece.

Abstract: An instrument guide is removably inserted into a proximal portion of a cannula and extends to a distal end of the cannula to guide and support multiple surgical instruments within the cannula. The instrument guide is designed to be manufactured by injection molding of plastic material. The instrument guide includes a tube and several radial walls connected to the tube to form passageways within the tube. The radial walls are joined to a core where they intersect. The tube and radial walls have substantially the same wall thickness and the core has a minimum diameter that is substantially larger than the wall thickness to facilitate delivery of plastic material. Portions of the tube and radial walls are thinner than the general wall and rib thickness to form guideways that support surgical instruments within the passageways. Channels may be formed on an outside of the tube to deliver insufflation gas.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: A surgical port is disclosed. The surgical port has a cannular channel. The surgical port also has one or more suture slots in communication with the cannular channel. The surgical port further has a pair of cam grips for each of the one or more suture slots, each pair of cam grips comprising opposing gripping arms configured to allow suture to be pulled through the opposing gripping arms in a direction away from the cannular channel and to resist suture movement in a direction towards the cannular channel.

Abstract: Intravascular delivery system is designed for a safe and efficient access to secondary and tertiary vascular structures, such as the branches of the coronary sinus, to enhance the delivery and deployment of various catheters, such as, for example, pacemaker electrical leads. The over-the-wire system features a straight, or alternatively shaped, micro-catheter distal tip of an inner catheter that seamlessly cooperates with a peel-away reinforced outer catheter. The inner catheter and the peel-away reinforced outer catheter are advanced in their engaged mode of operation towards (or beyond) the target site. Subsequently, the inner and outer catheters are disengaged, and the inner catheter is removed from the outer catheter. A pacemaker lead may be advanced over the wire inside the outer catheter to the target site for deployment. Subsequently, the outer catheter is easily split and may be rapidly removed from the blood vessel.

Abstract: A depth limiter configured for use with a surgical cannula includes an annular base having a boss that extends about a longitudinal axis and has a boss lumen configured to receive the surgical cannula. A latch arm coupled with the annular base overlies the boss and includes an arm opening configured to align with the boss lumen to receive the surgical cannula. The latch arm is movable relative to the annular base between a release position and a lock position. In the release position the arm opening is positioned coaxially with the boss lumen such that the latch arm is configured to permit longitudinal movement of the depth limiter along the surgical cannula. In the lock position the arm opening is positioned non-coaxially with the boss lumen such that the latch arm is configured to inhibit longitudinal movement of the depth limiter along the surgical cannula.

Abstract: Correction of a scoliotic curve in a spine comprises the steps of implanting an expanding rod isolated completely under the skin and attached to selected portions of the scoliotic curve of the spine at opposing ends of the rod; and producing a controlled force by means of expansion of the rod over at an extended time period under externa control until a desire spinal curve is obtained. An incremental force is generated to stretch the scoliotic curve of the spine between the selected portions where attachment of the rod is defined. The controlled force is provided steadily for at least one month or alternatively 1-3 months. Multiple rods may be employed each associated with a different scoliotic curve of the spine or a different portion of the scoliotic curve.

Abstract: A spinal manipulation instrument, system, and method may use a driving rod to move instrument arms toward or away from one another to compress or distract between selected vertebrae to which the arms are connected. Two arms may be coupled to the driving rod. A threaded collar may axially engage one of the arms, to translate that arm along the driving rod with respect to the other arm. The other arm may be at a fixed axial location or driven by another, oppositely-oriented thread. The arms may be highly adjustable to accommodate a wide range of anatomical variation between patients. Attachment members may be modular to interchangeably couple the arms across multiple platforms.

Abstract: Disclosed implants may include a first implant receiver and a second implant receiver each having an upper portion and a lower portion connected together by an arm portion, for example. In various embodiments, the upper and lower portions may define a longitudinal passageway extending through the upper and lower portions in a longitudinal direction of each implant receiver, and the arm portions may each define a rod passageway extending in a lateral direction, for example. In various embodiments, each receiver may include a crown having an outside thread pattern threadably engaged within the longitudinal passageway and for mating with a corresponding nut having a similar interior thread pattern. In various embodiments, a rod may extend in the lateral direction through the rod passageways In various embodiments, in a non-tightened position, the rod may freely move and in a tightened position, the arms constrain the rod from moving.

Abstract: A system of devices and methods for use by which one or more target motion segments of the cervical spine are stabilized without any violation of the cortical bone of the target vertebrae. The devices are brought against strategic aspects of these vertebrae, thus permitting the disclosed inventions to achieve secure control of each vertebra. Connecting elements then stabilize the constructs. Preferred and alternative embodiments of the invention are disclosed, along with methods of implantation, and adjunct devices used in the implantation of the disclosed invention.

Abstract: This disclosure discloses a line coupled to a spine of a user at two points such that the line can be movable relative to those two points. The line can be encased by a protective member between those two points. The line can be covered by a compound between those two points. The line can be guided between those two points.

Abstract: Various surgical instruments, implants, and their methods of use are disclosed. The surgical instruments are usable to insert various implants into a patient through an access portal in a minimally-invasive manner. The implants are rotatable between different orientations using the instruments to change the footprint of the implant and allow the implant to be inserted through the minimally-invasive access portal.

Abstract: Systems and method of using a surgical driver instrument are provided. The driver instrument includes a driver shank having a proximal end including a head connector for a bone construct. The instrument includes an inner sleeve having a length and configured to receive the driver shank therein and a handle member having a first end and a second end. The inner sleeve and the driver shank have a non-threaded connection. The instrument includes an outer sleeve connected to the second end and concentric with the inner sleeve and a sleeve actuator assembly coupled to the handle member. The sleeve actuator assembly includes a first position where a portion of the length of the inner sleeve extends out from the handle member and a second position where the portion of the length of the inner sleeve that is extended from the handle member is retracted into the handle member.

Abstract: Bone fusion system, plate system, guide, implant, kit and methods for using the bone fusion system, plate system, guide and implant are disclosed. The bone fusion system includes an alignment guide, an implant, and at least one fastener inserted through the implant. The alignment guide includes a body portion, a first lobe positioned at a first end of the body portion, a second lobe positioned at a second end of the body portion, and an extension member extending away from a first side of the body portion. The implant includes a body portion, a first arm extending away from the body portion in a first direction, a second arm extending away from the body portion in a second direction, and a third arm extending away from the body portion laterally between first and second arms. Finally, methods for using the bone fusion system, plate system, guide and implant are disclosed.

Abstract: A fixation system for coupling a first and a second portion of bone together. The fixation system includes a first fixation element, a second fixation element, and an interconnect. The first fixation element includes an external surface configured to engage the first portion of bone and a first tapered mating surface. The second fixation element includes an external surface configured to engage the second portion of bone and a second tapered mating surface. The interconnect includes a first and a second tapered surface disposed at generally opposite ends. The first and the second tapered surfaces are configured to frictionally engage the first and the second tapered mating surfaces of the first and the second element, respectively, to form frictional interference connections therebetween.

Abstract: A bone fastener includes a screw shaft having a proximal portion and a distal portion. The proximal portion is formed by a first manufacturing method and defines a distal face. The distal portion is formed onto the distal face by a second manufacturing method. In some embodiments, systems, spinal constructs, surgical instruments and methods are disclosed.

Abstract: A mixing and delivery system includes a compressible tube and a mixing apparatus. The compressible tube includes a reservoir configured for mixing and holding a surgical substance, an inlet portion for accommodating introduction of an element of the surgical substance into the compressible tube, and an exit port for enabling the delivery of the surgical substance to a target portion of an anatomy. The mixing apparatus is configured to be received through the inlet portion of the compressible tube for mixing elements of the surgical substance to form the surgical substance.

Abstract: An impactor according to an embodiment of the present invention comprises an adapter detachably coupled to a rotary power tool, wherein the adapter includes: a case part; a tool coupling part receiving a rotational force from the rotary power tool; a first rotating part rotating in association with rotation of the tool coupling part in only one direction among rotation directions of the tool coupling part; a striking part transfer part rotating in association with rotation of the first rotating part; a striking part which is moved, while compressing a first spring, in a first direction by rotation of the striking part transfer part and then moved in a second direction opposite to the first direction by a restoring force of the first spring; and a force transfer part moved in the second direction by contact with the striking part.

Abstract: A modular energy system including a header module and a module. The header module includes a display screen for displaying a user interface. The header module is configured to receive data, including safety critical data, from the module, control the display screen to cause the UI to display UI content based on the received data, the UI content including safety critical UI content based on the safety critical data, and transmit the displayed safety critical UI content to the module for verification thereby. The module is configured to confirm whether the transmitted safety critical data coincides with the displayed safety critical UI content. In the event that it is determined that they do not coincide, the header module and/or the module can be configured to stop the function(s) of the module, display an alert on the display screen, and take various other actions.

Abstract: Presented are a method and apparatus for evacuation. An exemplary fluid evacuation system includes a surgical apparatus having a fluid conduit therethrough. The system further includes a vacuum tube fluidly coupled with the fluid conduit, and an electrostatic precipitator fluidly coupled with the fluid conduit. Additionally, the system includes a vacuum source fluidly coupled with the vacuum tube, wherein the vacuum source is operable to create a flow of fluid through the fluid conduit, the vacuum tube and the electrostatic precipitator.

Abstract: Cartilage and other tissues are treated by generating a plasma in an interior space of a probe and exposing the tissue to the plasma. The plasma is released through a gap in a working end of the probe.

Abstract: A system and method can be used to denervate at least a portion of a bronchial tree. An energy emitter of an instrument is percutaneously delivered to a treatment site and outputs energy to damage nerve tissue of the bronchial tree. The denervation procedure can be performed without damaging non-targeted tissue. Minimally invasive methods can be used to open airways to improve lung function in subjects with COPD, asthma, or the like. Different sections of the bronchial tree can be denervated while leaving airways intact to reduce recovery times.

Abstract: An ablation system includes multiple electrodes configured to contact body tissue of a patient, including two or more ablation electrodes for contacting respective locations in a target organ and a return electrode. A signal-generating unit includes multiple signal generators, which are configured to apply respective composite signals to respective ones of the ablation electrodes. The composite signals include multiple, respective signal components, including respective ablation signals, having different, respective ablation-signal amplitudes and phases at a common ablation-signal frequency, and respective probe signals having respective probe-signal amplitudes and different respective probe-signal frequencies. A processor is coupled to measure the probe signals received by each of the multiple electrodes, and responsively to the measured probe signals, to control the ablation-signal amplitudes and phases.

Abstract: An electrode assembly for an electrosurgical pencil includes an insulative core configured to support an active wire around a peripheral surface thereof and a ground electrode coupled about the insulative core and adapted for insertion within an electrosurgical pencil. A hypotube is disposed between the ground electrode and the active pin and encapsulates the active pin to insulate the active pin from the ground electrode. An active pin is included that is adapted for insertion within the pencil and has a tensioning assembly including: a set screw with threads that engage grooves of the active pin such that, upon rotation, the set screw advances to secure the active wire within the active pin; and a nut is fixed within the hypotube that includes grooves that engage threads of the active pin such that, upon rotation, the active pin translates proximally to tension the active wire about the insulative core.