Abstract: A fluid delivery device adapted for microliter-scale injections of coronavirus vaccines across a dermal barrier of a patient, for example to the lymphatic system of the patient, is described. The present disclosure also provides methods of administering coronavirus vaccines across a dermal barrier of a patient, for example to the lymphatic system of a patient.

Abstract: A clot removal device for removing a clot from a body vessel is presented. The device can facilitate clot retrieval by expanding in such a way as to engage the clot over a significant surface area. The clot can have at least one firm portion and at least one soft portion. At least one firm portion of the clot can be pinched by a proximal portion of the device while at least one soft portion of the clot can be retained by the distal portion of the device upon extraction. However, dislodgement and removal of the clot can cause softer portions the clot to shear or break, resulting in small floating fragments of clot in the vessel no longer attached to the main clot. This device can also capture and retain sheared or expanded distal portions of the clot upon removal of the clot from a vessel.

Abstract: The present disclosure provides a surgical instrument comprising an instrument body with a distal end including a working portion, and a proximal end including a handle. The instrument body includes a first arm and a second arm that are pivotable relative to one another. Each of the first arm and the second arm having a handle portion of the handle and a portion of the working portion. And each of the handle portions of the first and second arms being configured to enable a user to control the instrument body and move the portions of the working portion of the first and second arms between opened and closed positions.

Abstract: Minimally invasive, multi-functional robotic surgical tool devices for use as lavaging, material aspiration or delivery surgical forceps, scissors or clamp or other device, consisting of a monolithic work element and open central lumen with various functional tips. Such devices may in use follow a central lumen of another device or over a wire in a longitudinal direction upon introduction to a body. Flush and vacuum transport mechanisms, imaging mechanisms or energy source mechanisms may be incorporated. Inner and outer sheaths which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks and provisions for simultaneous beak closing under rotation may be incorporated.

Abstract: An endoscopic tissue resection device configured to be attached at a distal tip of an endoscope is disclosed. The device comprises a cap, a snare sheath, a snare, and a spring wire. The snare comprises a collapsible snare wire configured to be retracted from the cavity of the cap into the snare sheath, the collapsible snare wire reversibly collapsing upon retraction, and to be advanced from the snare sheath into the cavity of the cap, the collapsible snare wire reversibly expanding upon advancement. The spring wire is reversibly deflectable from a resting state to a deflected state. In the resting state the spring wire orients and stabilizes an apex of the collapsible snare wire within the cap such that two opposing wire portions of the collapsible snare wire are positioned in apposition to a distal opening of the cap.

Abstract: Auger-based bone harvesting and delivery may be provided by a surgical device comprising: a cannula having first and second openings disposed on respective first and second ends; an auger, disposed within the cannula, including a flighting arranged around an auger shaft (aligned concentrically to the cannula); and a holding area in communication with the first opening. Harvesting may be performed by rotating, a cutting tip against a bone to collect tissue; and conveying the tissue to a holding area via the auger (that is co-rotated with the cutting tip). Delivery may be performed by inserting the first opening of the cannula into a delivery site; providing a graft material in a holding area in communication with a second opening of the cannula into contact with the auger; rotating the auger to convey the graft material to the delivery site via the auger and cannula.

Abstract: A surgical device providing a body defining a interior volume, a surgical tip configured to impart a vibration to a contacted object and a piezoelectric arrangement configured to initiate a piezoelectric effect to actuate a vibration in the surgical tip, wherein the surgical tip is configured to be inserted endoscopically into a patient.

Abstract: Some implementations provide a high-powered compact ultrasonic transducer having an integral piezoelectric ceramic force sensing element utilized to enable enhanced tissue selectivity with a piezoelectric based transducer. Some implementations additionally or alternatively relate to methods and apparatus for driving ultrasonic surgical devices, such as methods and apparatus that modulate an amplitude of a drive signal, provided to an ultrasonic surgical device, in accordance with a selected tissue selectivity level. For example, the amplitude of the drive signal for a given tissue selectivity level can be varied with time in accordance with amplitude modification parameters that are particularized to the given tissue selectivity level. Some of those implementations additionally implement a corresponding duty cycle, for the drive signal, that corresponds to the selected tissue selectivity level.

Abstract: A catheter for removing an object in a body lumen includes a rotatable drive shaft including a spiral portion having a spiral shape near a distal end of the drive shaft, an outer tube surrounding the drive shaft, a cutting member connected to the distal end of the drive shaft to be rotated by the drive shaft with respect to a rotation axis and by which the object is cut, a guide wire tube attached to a distal portion of the outer tube, extending substantially straight along a center spiral axis of the spiral portion, and having a first guide wire lumen, and a distal tip attached to a distal end of the guide wire tube and having a second guide wire lumen extending parallel to the rotation axis and communicating with the first guide wire lumen.

Abstract: A thrombectomy or atherectomy device (10) includes a thrombectomy or atherectomy catheter (12) including a cutter (20), and a physical barrier (22, 24) disposed proximate to the cutter. In some examples, the physical barrier (22, 24) can have a stiffness effective for the physical barrier to deflect a blood vessel having a thickness less than a first predetermined thickness threshold and effective for a thrombus or atheroma on an inner wall of the blood vessel to deflect the physical barrier.

Abstract: Device, system, and method for dry needling comprising a device having a surface area configured to surround a location on a user, one or more openings in the surface area, each opening supporting a directional needle guide configured to allow a needle to pass therethrough to the location on the user; and one or more needles configured to fit within each directional needle guide

Abstract: A method and apparatus are disclosed for an elongated introducer assembly and an elongated guidewire assembly. The elongated introducer assembly is manipulated and positioned proximate to a first biological wall. An elongated guidewire assembly is selectively maneuvered along the elongated introducer assembly and is comprised of a distal tip, distal portion, and elongated shaft section. The distal portion is further comprised of a flexible preset spatial geometry which comprises a distal length and distal deflective portion. The distal tip is used to puncture the first biological wall and the distal deflective portion directs the distal length away from a second biological wall positioned proximate to the first biological wall.

Abstract: A device includes an access cannula, a puncturing element, a handle. The access cannula includes a lumen extending therethrough. The access cannula is sized and shaped to extend through an endoscopic shaft to a target tissue within a living body. The puncturing element is sized and shaped to extend through the lumen of the access cannula and distally out a distal end of the access cannula. The handle includes a handle body and a mechanism for advancing the access cannula from a proximal position relative to the puncturing element, where a puncturing tip of the puncturing element is exposed distal to a distal end of the access cannula, to a distal position relative to the puncturing element, where the distal end of the access cannula covers the puncturing tip of the puncturing element.

Abstract: Trocar retractor apparatus and methods for use are described where an apparatus for positioning an instrument may generally include a substrate having a first surface and a second surface opposite to the first surface, an instrument positioning guide projecting from the first surface of the substrate, and one or more suction assemblies positioned along the second surface and in fluid communication with an interior of the substrate. The one or more suction assemblies may be attachable to a tissue region via a vacuum force applied through the one or more suction assemblies. The apparatus may also have the substrate configured to maintain a predetermined configuration when the vacuum force is applied.

Abstract: A rotatable chip-on-tip endoscope is configured to be operated with a single hand, with the palm holding the body of the device and one or two fingers operating a distal rotatable end of the handle that carries the needle. The needle is small in diameter, preferably less than 2.5 mm at its largest end. As the tip is rotated to view more widely in a patient's joint, for example, video processing electronics correct rotational orientation in real time to present a consistent moving image on a monitor.

Abstract: In an embodiment of the invention, a fixator for fixating bone fractures includes a Y-frame having superior, anterior and posterior arms. The arms may be slotted and may accept mounting hardware for supporting fixation pins or transfixion pins. Various components of mounting hardware may be able to be adjusted either in discrete steps or in continuous manner, for various degrees of either translation or rotation. The Y-frame may be rigid, or may have joints that allow either angulation or arm-twisting adjustment. Arms may be provided joinable interchangeably to a hub. A kit of such parts may be provided.

Abstract: A method for securing a longitudinal connection member assembly into multiple bone anchors by inserting the assembly into the bone anchors before or after the assembly is tensioned. The assembly includes a tensionable cord, an outer end blocker, and a set screw. The cord has a first end portion fixedly connected to a first structure, extends through a through-bore of a second structure, and has a second end portion that extends through a blocker through-bore of the outer end blocker. The outer end blocker has oppositely spaced lateral external planar surfaces and a threaded closed bore. The set screw is releasably engageable to the outer end blocker via the threaded closed bore. The method further includes tensioning the cord from the second end portion, holding the planar surfaces during tensioning of the cord within the blocker, and securing the tensioned cord to the outer end blocker by the set screw.

Abstract: A device to modulate growth of an immature rib comprising a spring plate configured to provide an elastic spring function in bending along its length; two rib hooks each configured to secure the spring plate to the immature rib; and a transverse hook or a pedicle screw configured to secure the spring plate to the vertebra.

Abstract: The present invention provides methods of forming flexible implant devices and U-bridge implants that drive into curved trajectories to enhance implant fixation in bone. The curved drilling trajectories avoid regions of low bone mineral density, such that flexible implants and/or U-bridge implants driven into the curved drilling trajectories are anchored in regions of high bone mineral density to improve the stability of bone fixation. The flexible implants and U-bridge implants are suitable for several applications, including but not limited to spinal fixation, orthopedic bone fixation, and neurosurgery.

Abstract: An orthopedic plate is specifically configured for use in osteotomies, in which part of the plate extends into a portion of a first bone segment and part is external to the cortical surface of an adjacent bone segment to fix the segments to allow them to fuse. The plate has a first end and a second end where the end which is inserted into the bone has a chamfer and a through hole having a hole axis optionally at an oblique angle to the longitudinal axis of the plate, and which can receive a screw, peg or pin. The second end of the plate includes a locking screw hole and optionally including a compression slot extending in a direction toward a screw hole in the opposing end. Optionally, the non-locking hole has a shroud that forms an arc or portion of a cylinder over the hole. A plate driver having a recess that holds the plate is used to insert the plate into the bone.

Abstract: Certain embodiments of the invention provide plates for treating periarticular fractures or other non-full body weight bearing applications that combine polyaxial fixation with a low profile and enhanced contouring that more closely conforms to bone. Such plates can be designed to achieve buttressing effect and/or to be used in a reinforcement mode. Other features can be combined with these. Such plates can be created for use on bone sites such as on a tibia, fibula, metatarsal, calcaneous, other foot bone, humerus, radius, ulna, spinal, maxillofacial, as well as sites on other bones.

Abstract: An orthopedic fastener may include a shaft and a plurality of petals extending helically around the shaft. Each of the plurality of petals may include a proximal face and a distal face. The proximal face may include a parabolic contour formed as an undercut parabolic portion of the proximal face. The plurality of petals may be configured to generate and progressively increase an amount of compression of trabecular bone through which the petals advance during implantation in a bone, and distribute the compressive forces along a length of the shaft.

Abstract: An orthopaedic bone stabilisation device includes an elongate and integrally formed body having a length extending between proximal and distal ends. The elongate body includes a first threaded section having a head at the proximal end, the head configured to interface with a driver, the threaded section having external threads extending along a length of the first threaded section. The first threaded section extends between the proximal end and a first location of the elongate body. The first threaded section tapers from the proximal end to the first location such that the outer thread diameter of the first section gradually decreases from the proximal end to the first location of the elongate body. The device further includes a second threaded section having external threads, a length, and a substantially uniform thread diameter, and extends between the distal end of the elongate body and a second location of the elongate body.

Abstract: A collinear reduction clamp including a compression rod, an arm, and an advancing mechanism for moving the compression rod relative to the arm. In some examples, the rod may include a cannulated bore to enable a bone screw to be inserted therein. The rod may also include a cap. The cap including a bone screw washer. In use, a bone screw can be inserted through the cannulated bore of the rod, the bone screw passing through the washer thereby coupling the washer to the bone screw thereby enabling both the bone screw and the washer to be inserted into the patient's bone directly at the compression site. In some examples, the cannulated bore may be used in combination with first and second tubes and a guidewire to enable a cannulated bone screw to be inserted therein. In some examples, the arm may be configured as a length adjusting arm.

Abstract: A cannulated surgical instrument having a cannula lock configured to selectively lock and unlock a guidewire extending into the instrument's cannula. The instrument includes a cannulated shaft having a cannulated driving member attached to a proximal end of the cannulated shaft. The cannula lock is configured to selectively move between (i) a locked position where the guidewire is engaged and cannot move axially with respect to the cannula, and (ii) an unlocked position where the guidewire is disengaged and can move axially with respect to the cannula.

Abstract: A cryoablation catheter includes an inner lumen and an inflatable balloon surrounding the inner lumen. An inflow pipe is disposed within the inflatable balloon and is configured to introduce a refrigerant into the balloon. A thermocouple wire is disposed within the inflatable balloon and positioned adjacent the inflow pipe. The thermocouple wire is configured to measure an internal temperature of the balloon. The cryoablation catheter further includes an isolation guide disposed within the inflatable balloon. The isolation guide includes a central bore configured to receive the inner lumen, an inflow bore configured to receive the inflow pope, and a thermocouple bore configured to receive the thermocouple wire. The thermocouple bore is spaced from the inflow bore along the isolation guide.

Abstract: Proposed is a filter module including a filter that filters impurities out in the coolant emitted from a cartridge which includes a housing and a cap. The filter module may include not only a filter accommodation member including a support surface and a perforating member protruding from the support surface but also a first sealing member with a first external diameter including a through-hole fitted into the perforating member. The first sealing member may be transformed into a shape with a second external diameter—the second external diameter is smaller than the first external diameter—corresponding to the width of an inlet of the housing in which the first sealing member accommodates a cap when the cap is perforated by the perforating member.

Abstract: A method and system of providing therapy to a patient's uterus is provided, which can include any number of features. The method can include the steps of inserting a uterine device into the uterus and performing a uterine integrity test to determine that the uterus is intact and not perforated. If it is determined that the uterus is not perforated, a patency test can be performed to determine that the uterine device is not clogged or embedded in tissue. If the uterus is intact and the device is not clogged or embedded in tissue, the uterus can be treated with the uterine device, e.g., uterine ablation. Systems for performing these methods are also disclosed.

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 electrosurgical device that comprises a deployable electrode tip and concurrent smoke evacuation and suction control integrated in a single apparatus. An electrode tip is supported for motion so that when a selected button is pressed, the tip extends past a suction tube and is activated for cutting and/or coagulating tissue. In this configuration, the suction tube is in a useful position to evacuate surgical site smoke. When pressure on the selected button is released, the tip moves into a retracted position and is deactivated. This allows for the suction tube to evacuate any remaining smoke and suction fluid/solid debris at the surgical site. Optional suction tube sizes and configurations with a control valve for finger-modulated suction can be exchangeable as per surgical demands. This device would allow surgeons to smoothly transition from surgical dissection with smoke evacuation to fluid and debris suctioning to optimize the surgical process.

Abstract: A microsurgical probe employs an optional probe support structure; an optical fiber for providing a feed path for an emission wavelength; a chemical feed path for delivering a chemical; a resonator motor; and a probe accessory tool. A microsurgical system additionally employs a sensor and an artificial intelligence (AI) system to assess conditions based on data provided by the sensor. The system can be employed to remove tumor tissue that is interwoven with healthy tissue. This system can also be employed to fertilize old, inflexible ova.

Abstract: A method and apparatus are disclosed for providing forward fluid delivery through an electrosurgical device, while avoiding coring when energy is delivered to the electrosurgical device. The device has a distal face defining an opening, with the distal face including at least one cutting portion and at least one non-cutting portion. An embodiment of the electrosurgical device for puncturing tissue includes an elongate member defining a lumen for fluid; a distal portion including an electrode and the distal face which defines at least one aperture. The portion of the at least one cutting portion defines a leading portion partially surrounding a circumference of the at least one aperture wherein the outer diameter of the at least one of the distal portion of the electrosurgical device or the electrode decreases towards a distal tip of the electrosurgical device.

Abstract: A system having an electrode probe and a temperature sensing device, wherein the temperature sensing device is positionable within the electrode probe. The probe can have an elongate electrode body, at least two electrode contacts disposed on the electrode body, and a lumen defined within the electrode body, and the temperature sensing device can have an elongate outer body having a lumen, an elongate inner sensing body disposed within the lumen, and at least one temperature sensor disposed on the elongate inner sensing body. The system in certain embodiments can also have a controller configured to receive temperature information from the temperature sensing device and use the temperature information to adjust energy supply to at least one of the at least two electrode contacts.

Abstract: An ablation system includes a retractable sheath including a lumen; a first electrode in the lumen; a pre-bent telescopic tube extendable from the lumen and including a second electrode, wherein the first electrode and the second electrode are configured to deliver an electric field energy to target tissue in a patient.

Abstract: A system and related methods for repairing a tissue defect having a locating or centering member configured to extend into the tissue defect and to locate one or more components of the system relative to the tissue defect. The locating member can define a non-circular outside shape.

Abstract: Aspects of the present disclosure are directed to, for example, a high-thermal-sensitivity ablation catheter tip including a thermally-insulative ablation tip insert supporting at least one temperature sensor electrically coupled to a flexible electronic circuit and encapsulated, or essentially encapsulated, by a conductive shell. Also disclosed is a method of controlling the temperature of an ablation catheter tip while creating a desired lesion using various forms of energy and energy delivery.

Abstract: A medical system includes a catheter, a light source, a detector, a circulator, and a processor. The catheter includes a distal-end assembly for performing a medical operation on tissue in a cavity of an organ of a patient, the distal-end assembly including an optical fiber configured to guide transmitted light to interact with the tissue of the cavity, and to guide returned light that interacted with the tissue. The light source is configured to produce the transmitted light. The detector is configured to measure the returned light. The circulator is configured to couple the transmitted light from the light source to the optical fiber, and to couple the returned light from the optical fiber to the detector. The processor is configured to identify a contact of the distal-end assembly with the tissue based on the returned light measured by the detector, and to indicate the identified contact to a user.

Abstract: The present disclosure relates to devices, systems and methods providing evaluation and feedback to an operator of a device providing neuromodulation treatment, such as modulation of renal nerves of a human patient. In one embodiment, for example, a system monitors parameters or values generated before treatment. Feedback provided to an operator is based on the monitored values and relates to an assessment of various electrical properties associated with an electrode carried by a catheter. The electrode measures an electrical property of biological material making contact with the electrode while deploying the electrode, the electrical property being dependent on a ratio of a wall-interface area to a fluid-interface area.

Abstract: The disclosed invention relates to an improved system and method for treatment of soft tissue, e.g., for treatment of a snoring condition. The system can include a laser source; a hand piece; and a device for directing radiation emitted by the laser source to a treatment area (e.g., an oral treatment area). In some cases, the handpiece can include an optical element (e.g., a lens) mounted within a replaceable cartridge and adapted to modulate a laser beam such that it is non-ablative, prior to its delivery to a treatment region. In various embodiments, the system includes a CO2 laser capable of performing treatment in a more efficient manner than conventional techniques.

Abstract: A system and method and system for providing preoperative patient intraoral scanning for diagnosis and preparation of a treatment plan utilizing the proposed system in advance of the crown surgery and intraoperative patient intraoral scanning for system assessment and verification for the method of treatment. More specifically, the proposed invention proposes a method and system of patient intraoral scanning to identify the best predesigned crown for use for the patient and develop a plan for intraoral surface treatment for the identified predesigned crown and automated crown inventory management.

Abstract: A method for providing a collision model includes detecting an item of patient information that has an item of information on a spatial placement of an entry point of a medical object into an object undergoing examination. The item of patient information is registered with a movable medical device. The method also includes detecting an item of object information that has an item of information on a geometry and spatial position of a manipulator for moving the medical object. The manipulator includes a motion device and/or a member of technical medical personnel. A relative placement of the manipulator in relation to the object undergoing examination is determined based on the item of patient information and the item of object information. The collision model is provided for the purpose of moving the medical device based on the relative placement and the item of object information.

Abstract: A system and methods for supporting minimally invasive surgery, involving a control module configurable to: receive an initial MRI image from an MRI imaging device; transmit the initial MRI image to a planning module configured to determine a surgical plan; receive the surgical plan from the planning module; transmit the surgical plan to a guidance module configured to operate with a medical instrument and the MRI imaging device, the medical instrument configured to couple with an MRI micro-coil, and the MRI imaging device configured to operate with the MRI micro-coil; and receive, in real-time, a subsequent MRI image from the MRI imaging device operating with the MRI micro-coil during guidance of the medical instrument.

Abstract: Methods and techniques for using an augmented reality device for determining an orientation of an instrument for inserting a medical device are provided. One such method includes simulating an insertion point and an orientation of a simulated surgical hardware installation on a diagnostic representation of a bone, and using an augmented reality based electronic device to align an instrument for inserting a surgical hardware installation at a desired orientation through an insertion point of the bone by displaying visual indicia indicating the insertion point and the orientation of the simulated surgical hardware installation. Disclosed herein is also a system and method having a concentric shape alignment system for medical device placement in the body, such as in a bone.

Abstract: A system and device (110) for determining bone laxity. For example, the system includes a tracked probe (300) comprising at least one probe marker (310) and a computer assisted surgical (CAS) system (100). The CAS system includes a navigation system (130) and a processing device (110) operably connected to the navigation system and a computer readable medium configured to store one or more instructions that, when executed, cause the processing device to receive location information from the navigation system, generate (820) a surgical plan comprising a post-operative laxity assumption (720), collect (850) first motion information related to movement of the joint through a first range of motion, collect (860) second motion information related to movement of the joint through a second range of motion, determine (870) a post-operative laxity (710), and compare the post-operative laxity and the post-operative laxity assumption to determine laxity results.

Abstract: In some embodiments, the systems and corresponding methods for accurate and precise placement of joint replacement implants or to assess bony drilling, reaming or cuts are disclosed. A method for assisting in precise and accurate placements of joint replacement implants during a surgery comprises: receiving, by a pinless navigation system, electronic signals carrying data collected by sensors; wherein the sensors are pinless, are placed on a patient's skin, and generate the data by probing a plurality of locations within a patient's body; based on the data included in the electronic signals received from the sensors, calculating, by the pinless navigation system, angular and distance values, which are between the plurality of locations within the body, for performing a surgery on the patient.

Abstract: A tumor sensor system having an implantable probe and an auxiliary device, the probe having at least one sensor configured to generate an electric signal in response to a physical stimulus, the at least one sensor having a position sensor configured to sense a signal from a position tracking system, the sensed signal indicative of a position of the probe in a space, the position sensor having at least one electromagnetic sensor configured to cooperate with an external electromagnetic field generator, and the at least one electromagnetic sensor is configured to detect a property of the electromagnetic field and send it as an electric signal to the processing circuit, at least one antenna for data communication by means of inductive communication, an energy harvesting coil, and transmitting the data via the at least one antenna to the auxiliary device.

Abstract: A system for performing image-guided surgery includes an instrument having a first portion configured to define a trajectory into the body of a patient, a marker device and a user-interface component. A sensing device receives electromagnetic signals that are reflected or emitted from the marker device, and a processing system, coupled to the sensing device, includes at least one processor configured with processor-executable instructions to perform operations that include tracking the position and orientation of the instrument relative to the patient based on the signals received at the sensing device, receiving a signal from the user-interface component of the instrument indicating a user-input event, and saving the trajectory into the body of the patient defined by the first portion of the instrument in response to receiving the signal.

Abstract: The present invention relates to flexible sheath assemblies capable of being localized in three-dimensions (i.e., determining the location and orientation) in real-time based on two-dimensional x-ray images, and related systems and methods.

Abstract: A system for tracking at least one bone in robotized computer-assisted surgery, comprises a processing unit and a non-transitory computer-readable memory communicatively coupled to the processing unit and comprising computer-readable program instructions executable by the processing unit for: obtaining backscatter images of the at least one bone from a tracking device in a coordinate system; generating a three-dimensional geometry of a surface of the at least one bone from the backscatter images, the three-dimensional geometry of the surface being in the coordinate system; determining a position and orientation of the at least one bone in the coordinate system by matching the three-dimensional geometry of the surface of the at least one bone to a three-dimensional model of the bone; controlling an automated robotized variation of at least one of a position and orientation of the tracking device as a function of a processing of the backscatter images; and continuously outputting the position and orientation of

Abstract: The present teachings generally include a hand-held surgical robotic system for supporting a surgical tool, the handheld surgical robotic system comprising a hand-held portion, a tool support movably coupled to the hand-held portion, the tool support configured to support a surgical tool, a plurality of actuators operatively interconnecting the tool support and the hand-held portion, the plurality of actuators configured to move the tool support relative to the hand-held portion in a plurality of degrees of freedom, a controller in communication with the plurality of actuators and a flexible circuit connecting the controller with each of the plurality of actuators, such that the flexible circuits are arranged to maintain the connection between the controller and the plurality actuators and/or an input module while the tool support is moved in the plurality of degrees of freedom relative to the hand-held portion.