Abstract: Provided herein are systems for preparing and delivering fibrin sealant to a surface and methods of use thereof. In one embodiment, the system comprises: a. a quantity of a liquid mixture disposed within a container, the mixture comprising: I. fibrin or II. fibrinogen and Factor II; and b. a resin bed disposed within a vessel, the vessel capable of being in fluid communication with the container, wherein when in fluid communication, passage of the mixture through the vessel results in modification of the concentration of small molecules inhibitor(s) and/or inducer(s) within the mixture, favoring fibrin clot formation.

Abstract: A nebulizer capable of reliably intermittently applying a biological tissue adhesive is provided. A biological tissue adhesive nebulizer includes a first tube 30 for injecting a first solution containing a first component, and a second tube 30 for injecting a second solution containing a second component that promotes clot formation of the first component. The first solution injected from the first tube and the second solution injected from the second tube are mixed to generate and spray a biological tissue adhesive. A partition wall 34 is provided between a distal end 31 of the first tube and a distal end 31 of the second tube.

Abstract: The present invention is directed to a variable length applicator system for delivery of at least one medically useful liquid, comprising an elongated, telescopically extendable, variable length cannula having a liquid pump containing said liquid connected to said cannula at a proximal end, and a spray nozzle mounted on said cannula at a distal end; a coiled and extendable tubular conduit connected to and in fluid communication with, both said liquid pump and said spray nozzle; wherein an axial extension of said cannula is configured to cause a matching axial extension of said coiled tubular conduit.

Abstract: The present invention refers to a dural sealing system (100) comprising an implant (10), joined to a guiding thread (20); a transfer device (30), provided with a grip portion (30a) and a hollow portion (30b), said hollow portion (30b) terminating, at a first end, in a nozzle (30c) that can be coupled to an epidural needle (200), said hollow portion (30b) also terminating in a second end fitted with an entry region (30d); and an introductory device (70) comprising a tube (70a) with a hollow interior section, provided with a first free end and a second closed end, attached to a stop (70b).

Abstract: A device for sealing an aperture in a tissue includes: a foot including a distal portion configured to be disposed distal to the tissue when the device is implanted in a position to seal the aperture; and a flexible wing positionable against a distal surface of the tissue adjacent the aperture such that the flexible wing is disposed between the distal portion of the foot and the distal surface adjacent the aperture.

Abstract: Retractor assemblies and methods of using them to retract tissue. A retractor assembly as described herein may include first and second arms pivotally coupled and each arm formed of a plurality of stacked and separated plates, spaced to define a gap therebetween, providing strength while affording a reduction in weight of the retractor assembly. The retractor assembly may also include a ratcheting locking mechanism.

Abstract: Medical devices for cinching and cutting one or more suture, and methods for making and using such devices are disclosed. An example medical device may include a shaft, a sleeve attached to the shaft, cutter slidable within the sleeve, a cinch sleeve releasably coupled to the sleeve, and a cinch member. An elongated inner shaft may extend through and be longitudinally movable within the elongated shaft, sleeve, cutter, cinch sleeve, and cinch member. The inner shaft may be actuated to cinch and cut one or more suture disposed within the device.

Abstract: Suturing apparatuses can be configured to suture biological tissue, such as an anatomical valve. The suturing apparatuses can include a suturing device having an elongate shaft having a proximal end and a distal end, one or more tissue grasping arms, and a handle with actuators. The suturing device can further include at least two needles. One of the tissue grasping arms can have at least two suture mounts each loaded with a suture portion. The suture portions on the suture mounts can form a single suture strand. Methods for suturing bodily tissue may be performed with the suturing apparatuses. The tissue grasping arms can grasp tissue therebetween and at least two needles can be deployed toward the suture mounts, engage the suture portions, and be retracted through the tissue. A knot can be tied on the ends of the suture strand retrieved by the needles.

Abstract: In one embodiment, a multi-layer suture fastener that includes a generally disc-shaped body defining a plurality of axially spaced-apart layers. Each layer can include an inner axial surface and an outer axial surface. A suture opening can extend from the inner axial surface to the outer axial surface of each layer. The suture openings can have an open configuration and a closed configuration. One or more lines of suture can be passed through the suture openings when in the open configuration. The suture openings can be placed in the closed configuration. In the closed configuration, the one or more lines of suture can be restricted by radial surfaces of the suture opening from sliding through the suture openings in at least one longitudinal direction of the one or more lines of suture.

Abstract: The present application provides a suture structure for medical surgery and a process for making the same. The suture structure includes: a thread head core, a winding yarn and a suture connection yarn. In particular, the thread head core is formed by bundling a plurality of thread core yarns; a connection section is provided at a first end of the suture connection yarn; the connection section is attached to the thread head core along a length direction of the thread head core; a second end of the suture connection yarn extends out from the thread head core at the middle of the thread head core; the thread head core and the connection section are wound along the length direction of the thread head core to form a thread rod; and the core yarn, the winding yarn and the suture connection yarn are made of thermoplastic resin fibers.

Abstract: Devices, systems and/or methods for repairing soft tissue adjacent a repair site. In one embodiment, a repair device includes a plate member and an anchor. The plate member having a periphery, the plate member configured to be positioned along an outer surface of the soft tissue. The anchor includes a base and six legs extending from the base, the six legs extending from the base being moveable to a curled configuration such that the six legs wrap around separate portions of the periphery of the plate member with the soft tissue therebetween. In this manner, the repair device may be anchored to the soft tissue.

Abstract: A system using a guide to assist in insertion of a helicoidal member in a target biological tissue. The system adheres to tissues using suction to allow insertion of the helicoidal member.

Abstract: A surgical instrument includes a shaft assembly, an end effector, a firing system, and a firing lockout assembly. The end effector is operatively coupled with the shaft assembly. The end effector includes first and second jaws. The first jaw includes an anvil. The second jaw is configured to removably receive an unspent staple cartridge. The firing system extends through at least a portion of the shaft assembly and the end effector. The firing lockout assembly is selectively coupled with the firing system. The firing lockout assembly is disposed proximal to the end effector. The firing lockout assembly is configured to allow actuation of the firing system in an unlocked configuration in response to the unspent staple cartridge being coupled with the second jaw; and inhibit actuation of the firing system in a locked configuration in response to the unspent staple cartridge being absent from the second jaw.

Abstract: A surgical stapling assembly is disclosed. The assembly can include a cartridge body having cavities defined therein forming a pattern of openings in the deck of the cartridge body. The pattern can include longitudinally-repeating clusters of cavity ends. The assembly can also include fasteners removably positioned in the cavities. The pattern of openings can comprise openings on a first side of the cartridge body comprising inner openings each defining an inner proximal-to-distal axis oriented parallel to the longitudinal axis, outer openings each defining an outer proximal-to-distal axis obliquely-oriented relative to the longitudinal axis at an outer angle, and intermediate openings each defining an intermediate proximal-to-distal axis obliquely-oriented relative to the longitudinal axis at an intermediate angle, wherein the intermediate angle is different than the outer angle.

Abstract: Stapling assemblies for use with a surgical stapler are provided. In one exemplary embodiment, the stapling assembly includes a cartridge having a plurality of staples disposed therein and a non-fibrous adjunct formed of at least one fused bioabsorbable polymer and configured to be releasably retained on the cartridge. Adjunct systems for use with a surgical stapler are also provided. Surgical end effectors using the stapling assemblies are also provided. Methods for manufacturing stapling assemblies and using the same are also provided.

Abstract: Methods for fabricating an anvil for a surgical stapling device. Various methods include forming an anvil body from a first material and a deformable anvil tip from a second material and attaching the deformable anvil tip to a distal end of the anvil body with a deformable second attachment member. Other methods include molding a deformable anvil tip to a distal end of an anvil body.

Abstract: A surgical stapler includes a first stapler half including an anvil surface having a plurality of staple forming pockets, and a second stapler half configured to releasably couple with the first stapler half. The second stapler half is operable to deploy staples toward the anvil surface. The stapler also includes a projection positioned on one of the stapler halves and extending laterally relative to a longitudinal axis of the stapler. The stapler halves are configured to pivot relative to each other about the projection. The stapler further includes a locking member positioned on the other of the stapler halves. The locking member is configured to translate along the longitudinal axis of the stapler between a locked state in which the locking member selectively captures the projection and an unlocked state in which the locking member selectively releases the projection. The locking member is biased proximally toward the locked state.

Abstract: A cartridge assembly includes a channel and a removable assembly in releasable engagement with the channel. The removable assembly includes a cartridge body and a support plate. The cartridge body includes an engagement structure disposed adjacent a proximal end thereof. The support plate is configured to mechanically engage the cartridge body and includes an engagement structure disposed adjacent a proximal end thereof. The engagement structure of the cartridge body is configured for longitudinal alignment with the engagement structure of the support plate. The engagement structures of the cartridge body and the engagement structure of the support plate are configured to mechanically engage the engagement structure of the channel when the removable assembly is engaged with the channel.

Abstract: A surgical instrument is disclosed herein. The surgical instrument can include an end effector that includes jaws configured to transition between an opened condition and a closed condition, a plurality of electrodes positioned within the jaws of the end effector, a control circuit, and a memory configured to store an algorithm configured to cause the control circuit to determine an impedance signal based on signals received from the plurality of electrodes, detect a media positioned between the jaws of the end effector based on the determined impedance signal, determine a position of the detected media based on the received signals, and generate an alert associated with the detected media and the determined position.

Abstract: Surgical fasteners for use with articulating surgical instruments are disclosed. In one embodiment, a surgical fastener may include a head, a shaft extending distally from the head, and a through bore extending through the shaft from a proximal surface of the head to a distal end of the shaft. A fastener carrier of a surgical instrument may be slidably received in the through bore, and the through bore may be sized and shaped to have two or fewer contact points with the fastener carrier when the fastener carrier is in a fully articulated configuration. In another embodiment, a fastener may include a head, a shaft extending distally from the head and including a distal tip, a sloped surface sloping toward the distal tip, and a through bore passing through the head, shaft, and sloped surface. The sloped surface may terminate at two shoulders located on opposing sides of the through bore.

Abstract: A staple cartridge for use with a surgical instrument, the staple cartridge including: a longitudinal slot; a longitudinal row of obliquely-oriented inner staples positioned adjacent the longitudinal slot; a longitudinal row of obliquely-oriented outer staples; and a longitudinal row of obliquely-oriented intermediate staples. The longitudinal row of obliquely-oriented intermediate staples being positioned on the first side of the longitudinal slot intermediate the longitudinal row of obliquely-oriented inner staples and the longitudinal row of obliquely-oriented outer staples. The first lateral spacing being defined between the distal end of a staple of the longitudinal row of obliquely-oriented inner staples and the distal end of a staple of the longitudinal row of obliquely-oriented outer staples.

Abstract: A cover for an articulation joint that is supported in an elongate shaft assembly of a surgical instrument that is operably coupled to a surgical end effector that includes at least one end effector conductor therein. The cover includes at least one electrically conductive pathway that extends from the distal end of the cover to form an electrically conductive pathway from the end effector conductor to a shaft conductor on the elongate shaft assembly while facilitating operation of the articulation joint. Various conductor arrangements facilitating the passage of electrical current between an end effector to a control system across the articulation joint are also disclosed.

Abstract: A wound closure device in the form of a force modulating deep skin staple. The deep skin staple includes a bridge portion extending along a longitudinal axis to support a first set of staple legs and an opposing second set of staple legs. Each staple leg coupled to the bridge portion via a spring arm. Each staple leg angled towards a middle section of the bridge portion. The staple legs designed to modulate forces with a wound down into the reticular dermis layer when applied to the wound.

Abstract: A medical device may include a main shaft extending from a proximal end to a distal end; an actuator at a proximal portion of the medical device; an end effector positioned at a distal end of the main shaft and comprising a first jaw and a second jaw; a motor; and a torque amplification system. The torque amplification system may include a driveshaft coupled to the motor; a spring coupled to the driveshaft and configured to expand or contract in a proximal or a distal direction relative to the driveshaft; a hammer moveably coupled to the driveshaft; and an anvil coupled to the end effector and abutting the hammer. The anvil may be configured to provide a rotational power output to the end effector to move the first jaw and/or the second jaw.

Abstract: An anvil buttress loading system includes an anvil assembly, an anvil buttress loading tool, and an anvil buttress. The anvil buttress is retainable on each of the anvil buttress loading tool and the anvil buttress, and is transferrable from the anvil buttress loading tool to the anvil assembly.

Abstract: An apparatus includes a plurality of links and a plurality of beads interconnected together using the plurality of links. Each link of the plurality of links defines a chord length. The plurality of beads is configured to be arranged in an annular arrangement. Each bead of the plurality of beads includes at least one magnet configured to emit a magnetic field. The annular arrangement is sized and configured to form a loop around an anatomical structure in a patient. The loop in the expanded configuration is configured to permit fluid flow through the anatomical structure. Adjacent magnetic fields of adjacent magnets of the adjacent beads are configured to interact until separated past a minimum threshold in response the annular arrangement moving from the contracted configuration to the expanded configuration. The minimum threshold is based on the chord length of the links.

Abstract: A device includes an elongated hollow member having an open distal end for receiving tissue therein and at least one exterior groove for loading at least one ligation band thereon. The device also includes a band deployment sleeve slidable over the exterior of the hollow member and configured to move from a radially expanded position to a radially contracted position in which, when the band deployment sleeve slides longitudinally over the hollow member, the distal portion engages the at least one ligation band. A closing sleeve slidable over the exterior of the band deployment sleeve is configured to constrain the distal portion from the radially expanded position into the radially contracted position. Retracting the closing sleeve proximally over the distal portion of the band deployment sleeve releases the distal portion from the radially contracted position into the radially expanded position.

Abstract: Tissue ligation systems and methods are provides to mechanically strangulate abnormal or undesirable tissue. Tissue ligation systems include a multi-lumen catheter having an outer diameter smaller than the inner diameter of a standard endoscope channel such that the catheter can be inserted into the endoscope. Tissue ligation systems also include a ligation apparatus with an expandable hood disposed at the distal end of the catheter. A suture extends through a lumen of the catheter and has a distal loop portion that can strangulate tissue.

Abstract: An apparatus includes at least one link and a plurality of beads. The plurality of beads are joined using the at least one link and configured to be arranged in an annular arrangement. Each bead includes at least one magnet. The annular arrangement is sized and configured to form a loop around an anatomical structure in a patient. Adjacent beads are magnetically attracted together at a plurality of magnetic interfaces that include first and second magnetic interfaces. The first magnetic interface has a first magnetic field strength. The second magnetic interface has a second magnetic field strength that is less than the first magnetic field strength so that the beads forming the second interface are configured to separate prior to the beads forming the first interface when the loop moves from the contracted configuration to the expanded configuration, thereby providing uniform radial expansion of the loop.

Abstract: An apparatus includes at least one link and a plurality of beads. The plurality of beads is joined using the at least one link and is configured to be arranged in an annular arrangement. The annular arrangement is sized and configured to form a loop around an anatomical structure in a patient. The annular arrangement is configured to move between a contracted configuration and an expanded configuration. The loop in the contracted configuration is configured to prevent fluid flow through the anatomical structure. Each bead includes a housing, a magnet contained within the housing, and a secondary element that is different from the magnet. The magnet is configured to emit a magnetic field. The magnets of the plurality of beads are configured to magnetically bias the loop toward the contracted configuration. The secondary element is contained within the housing and is configured to increase the magnetic field of the magnet.

Abstract: An aneurysm implant support device for treating an aneurysm at a bifurcation can include a body having a tubular lattice extending from an upper body section, through a mid body section, and to a lower body section. The upper body section can be sized, shaped, and otherwise configured for implantation in an aneurysm sac. The upper body section can include support elements positioned at the aneurysm neck which inhibit the embolic implants from exiting the aneurysm. The mid body section can have two large cell openings substantially larger than the cell openings over a majority of the tubular lattice. The two large cell openings can be placed across passageways from a stem blood vessel to branch blood vessels of the bifurcation. The lower body section can be sized, shaped, and otherwise configured to anchor within the stem blood vessel.

Abstract: Vascular access devices, systems, and methods of their use are provided. In one embodiment, a vascular access device includes a catheter, a balloon, and an inflation lumen. The catheter includes an elongate flexible shaft having a proximal end and a distal end with a primary lumen therethrough. The balloon is disposed about the distal end of the catheter. The inflation lumen is in fluid communication with the balloon and extends toward the proximal end of the shaft of the catheter. The balloon is inflatable into a shape having a first open end, a second open end, a sidewall between the first and second open ends, and a passageway therethrough, which, when the balloon is deployed and inflated within a vessel, permits blood flowing in the vessel to flow through the passageway.

Abstract: A device for temporarily protecting a neck of an aneurysm of a blood vessel is provided. The device includes a plurality of wires coiled to form a collapsible frame configured to expand and substantially conform to a shape of an inside surface of the blood vessel while the aneurysm is being treated. The device includes a retention wire disposed at a proximal end of the frame of the plurality of wires. The device includes a cover comprising at least a first portion configured to be disposed directly against a neck of the aneurysm while the aneurysm is being treated, the first portion having a first porosity to blood flow. Related methods of use and manufacturing are also provided.

Abstract: Vascular expandable devices and associated methods are disclosed herein. An expandable vascular device can include a generally tubular sidewall formed of a plurality of braided strands. The device can have a compressed state for delivery in which the device has a compressed state diameter of 0.027 inches or less. The device can have an expanded state in which the device has an expanded state diameter. A full expansion distance of the device corresponds to a longitudinal unconstrained distance at which the distal end of the expandable device attains the expanded state diameter. The full expansion distance can be 20 mm or less.

Abstract: The present disclosure relates to repair devices configured for use in fixing or approximating tissues, such as cardiac valve tissues and particularly the leaflets of a regurgitant mitral valve. The repair device includes a shaft, a pair of proximal elements pivotally coupled to the shaft and extending from the shaft, and a pair of distal elements pivotally coupled to the shaft and extending from the shaft. The proximal and distal elements are configured so that targeted tissue can be grasped therebetween. The distal elements and/or the proximal elements include adjustable arms that can be extended and retracted to adjust the length of the gripping elements to provide more effective grasping of targeted tissues.

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

Abstract: The ligation device includes a clip unit, an applicator, and the applicator includes a sheath, an operation wire, a second link that is provided on the operation wire, and is capable of being fitted to the first link at a protrusion position, the second link configured to be restricted a releasing of fitting to the first link at an accommodation position, a slider connected to the operation wire and is configured to move with a first operation, and a limiter including a switch member configured to move in an intersecting direction that intersects a direction of the first operation with a second operation. The limiter is configured to limit a movement range of the slider when the second operation is not performed, and configured to release a limitation of the movement range of the slider with the second operation and to allow the second link to move toward the protrusion position.

Abstract: A surgical instrument employs a mass-spring system to drive the periodic reversal of the rotational direction of a bone dissection head. The instrument comprises a housing, a harmonic oscillator contained in the housing, an output member at least partially received in the housing and configured to be driven by the harmonic oscillator to reversibly rotate about a longitudinal axis in alternating directions, a dissection head having an attachment portion configured to be selectively driven in alternating rotational directions by the output member to remove material from a target bone, and a controller operable to initiate and stop the harmonic oscillator.

Abstract: Discectomy instruments and methods thereof. The discectomy instrument may include a cutter tip configured to release disc material between adjacent vertebrae. The cutter tip may be pivotable such that the cutter tip is positionable off-axis from an access port. The discectomy instrument may be a powered instrument with a constant velocity joint that acts as a point of articulation as well as drive transfer.

Abstract: Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient's positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

Abstract: Provided is a guide assembly for guiding a bone cutting tool through a small incision in the skin near the bone that allows movement of the cutting tool in the bone in a wide angle while the cutting tool is rotated about a pivot point that is located at the small incision. The guide assembly includes a 2-piece construction that includes a guide component that holds the cutting tool and a track component having a semicircular arc shape on which the guide component is slidably engaged whereby sliding the guide component along the track component guides the movement of the cutting tool to rotate about a pivot point that is the center of curvature of the semicircular arc shape of the track component.

Abstract: In some examples, a medical aspiration system includes a vacuum source; a vacuum tube coupled to the vacuum source; a vent tube; and a device configured to convert a constant suction force from the vacuum source into a periodic suction force, the device including a housing configured to receive a portion of the vacuum tube and a portion of the vent tube; a first plunger; a second plunger; and a rotatable cam configured to cause the first plunger to periodically compress the vacuum tube and to cause the second plunger to periodically compress the vent tube.

Abstract: The present disclosure relates to electrically controllable surgical tools. In general, surgical devices are provided having an electrically controllable, fingered operating end for use in angiography, endovascular and/or neurological surgery. The finger(s) at the operating end can be made from ionic polymer metal composite (IPMC) material to facilitate control of the finger(s).

Abstract: A clot removal device for removal of an occlusion from a lumen in a patient's body is provided. The clot removal device has a lumen, an elongated member positioned within the lumen and extending axially from a proximal end to a distal end of the lumen, a handle attached to the proximal end of the lumen, a first expandable member positioned along a length of the elongated member, a second expandable member positioned along the length of the elongated member, wherein the second expandable member is distal to the first expandable member relative to the handle.

Abstract: A retrieval device may have a contracted state and an expanded state. The retrieval device may include a sheath and at least three support members. Each of the support members may have a first portion with a first cross-sectional shape and a second portion with a second cross-sectional shape different from the first cross-sectional shape. A proximal end fixed of each of the support members may be coupled to the sheath, and a distal end may be movable relative to the sheath. The retrieval device may further include at least three movable members movable relative to the support members. Each movable member may extend through a lumen of one support member of the at least three support members and through a lumen of a different support member of the at least three support members.

Abstract: Various embodiments of the systems, methods and devices are provided for breaking up calcified lesions in an anatomical conduit. More specifically, an electrical arc is generated between two spaced-apart electrodes disposed within a fluid-filled balloon, creating a subsonic pressure wave. In some embodiments, the electrodes comprise a plurality of points or extensions that allow the electrical arc to form at any one of the plurality of points to, among other things, extend the electrode life.

Abstract: Conventional vasectomy techniques suffer from a number of disadvantages and potential complications, including, for example, a substantial risk for the development of hematomas, swelling, and post-surgical pain, a potential for spontaneous regeneration and undesired resumption of fertility, a need for a highly skilled surgical professional, as well as a long recovery period, accompanied by severe limitations on post-surgical activity. The present invention overcomes the disadvantages and deficiencies of the prior art by providing vasectomy instruments, kits, and methods that allow for a rapid, reliable, less invasive male sterilization procedure that may be readily, reliably and successfully performed by minimally skilled personnel around the world in a variety of medical settings.

Abstract: An end effector of a surgical tool may include a housing, a jaw support shaft, jaw members, and cam pulleys. The jaw support shaft is mounted to the housing and defines a pivot axis. The jaw members are supported on the jaw support shaft and are pivotable about the pivot axis. Each of the jaw members defines a support shaft slot therethrough and includes a pulley pin and a jaw pin. Each of the jaw members defines a jaw pin slot positioned to receive an opposing one of the jaw pins of the jaw members. The cam pulleys are coupled to the jaw support shaft and the jaw members. The cam pulleys are rotatable about the pivot axis to pivot the jaw members about the jaw support shaft.

Abstract: An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable. The electromechanical system includes a staple cartridge that includes a knife that is movable between a raised position and a lowered position.

Abstract: Determining orientation of cutting windows of a mechanical resection instrument. At least some of the example embodiments are methods including: sensing a location of a cutting window through an outer tube of the mechanical resection instrument, the sensing based on a magnetic field strength of a first magnet; sensing a location of a cutting window through an inner tube concentrically disposed within the outer tube, the sensing based on a combined magnetic field strength of the first magnet and a second magnet; and stopping a rotation of the inner tube relative to the outer tube with the cutting window through the outer tube and the cutting window through the inner tube in a predetermined orientation, the stopping based on the combined magnetic field strength.