Abstract: A method of treating a calculi mass can include using an ultrasonic probe to produce acoustic energy and fragment the mass. The method can include varying the frequency at which fragmentation occurs to treat the mass with a resonant frequency. The ultrasonic probe can have a distal tip for contact with the mass, where the tip has a morphology for concentrating stress on the mass. The ultrasonic probe can have two or more ultrasonic horns to allow for higher voltage and power levels.

Abstract: A method is disclosed for removing a vascular occlusion, such as a clot, from a blood vessel. A tubular sheath is inserted into the vessel and a self-expanding Nitinol mesh filter is deployed from a distal end of the tubular sheath at a location proximal to a clot. An inner catheter is advanced through the tubular sheath and through the mesh filter for contacting the clot. An expandable agitation element is provided along a distal end portion of the inner catheter for cutting or chopping the clot, thereby facilitating removal of the clot and improving blood flow through the vessel. Resulting clot particles are captured by the mesh filter. Negative pressure may be applied along a proximal end portion of the sheath for aspirating remaining particles. Certain embodiments of the method are well-suited for treating deep vein thrombosis and do not require the use of thrombolytic drugs.

Abstract: A tissue retrieval system can include a tissue retrieval bag with an elongate profile. The tissue retrieval bag can have a relatively large volume, but be rollable to a stowed configuration to fit in a relatively small diameter introducer. The tissue retrieval system can include one or more support arms coupled to the tissue retrieval bag, the support arms biased to position the tissue retrieval bag in an access position once deployed from the introducer. A tissue retrieval system can have a hybrid tissue retrieval bag including material properties that vary along the depth of the bag from an open end to a closed end. A tissue retrieval bag can be used in conjunction with an introducer, or as a stand alone tissue retrieval bag.

Abstract: Devices described herein include an actuated clot retrieval catheter system. The system includes a catheter having a frame disposed proximate the distal end of the catheter. The frame expands to form a seal with the inner wall of a vessel. In some examples, the frame also captures a clot for removal from the vessel. The frame is manufactured from a shape memory material that can be heat set into a predetermined shape. An electrical connection to an electronic circuit causes a current to run through the frame. The electrical resistance of the shape memory material causes the frame to heat and transition from a martensite to an austenite phase. When the frame is heat set into an expanded configuration, the current causes the frame heat and expand. When the frame is heat set into a closed configuration, the current causes the frame heat and collapse upon a clot.

Abstract: Medical devices include a ground link, a first actuator pivotably coupled to the ground link and a first movable element operatively coupled to the first actuator by a linkage. The linkage including: the ground link; a second link that is pivotable with respect to the ground link; a fourth link that is pivotable with respect to the ground link; and a third link having a main body extending from a first portion to a second portion and a blocking tab extending away from the main body. The medical device further including a second actuator operatively coupled to the ground link, the second actuator having a blocking surface including a blocking tab that is positioned to engage with at least a portion of the blocking surface of the second actuator to limit movement of the second actuator until the first actuator is at least partially actuated.

Abstract: Provided herein is a surgical instrument comprising a cap having a first and second aperture extending therethrough, a first extendable and retractable member having a distal end coupled to a first coupling, a first arm extending from the first coupling and pivotable with respect to the distal end of the first member, and a second arm connected to the first arm through a second coupling and pivotable, with respect to the first arm, a second extendable and retractable member having a distal end coupled to a third coupling, a third arm extending from the second coupling, the third arm pivotable, with respect to the distal end of the second member, and a fourth arm connected to the third arm through a fourth coupling and pivotable, with respect to the third arm, a first end effector connected to the second arm and a second end effector connected to the fourth arm.

Abstract: An implant for creating incisions in the tissues surrounding the bladder neck and the urethra of a patient, for relaxing the opening of the bladder, the implant includes a central connector and at least one wire, the wires extend radially outwardly from the center of the central connector, the wires apply continuous pressure on the surrounding tissues, the wires are foldable within an implant sheath for enabling delivery and extraction thereof, the implant is implanted within a restricted location of the urethra for a period of time for creating incisions at the locations where the wires apply pressure on the surrounding tissues.

Abstract: An apparatus is provided for scoring a treatment location in a vessel. A catheter includes an expandable element or inflatable balloon for achieving dilatation. A scoring element includes an elongated scoring wire having at least one ring for selective positioning over the inflatable balloon, which may then be inflated to provide scoring function in both a longitudinal and transverse direction. A plurality of the rings may be provided, and may be adapted for use with a variety of different sizes or lengths of balloons. Related methods are also disclosed.

Abstract: A system and method for cutting soft tissue with a retractable surgical cutting device. The device includes a handle, an actuator positioned thereon, and a sheath attached thereto, where the sheath surrounds a shaft with a blade attached to the distal end thereof. The device also includes a drive and locking mechanism connected to the actuator and to the shaft within the internal space of the handle, wherein the drive and locking mechanism is configured to move the shaft in the first direction and lock the shaft in the shaft first position in response to movement of the actuator in one of the first direction or the second direction, and wherein the drive mechanism is configured to move the shaft in the second direction and lock the shaft in the shaft second position in response to movement of the actuator in the other one of the first direction or the second direction.

Abstract: A surgical device including a cannula having a base member at a proximal end, a sidewall connected to the base member, and a bore defined by the base member and sidewall. The sidewall further has an opening into the bore between axially-extending edges of the sidewall. A configurable guide insert includes a combination track having a circular opening for insertion of a camera device and a slot opening for insertion of a cutting instrument. The configurable guide insert may be permanently or detachably coupled to the base member and is positionable in a right orientation for a procedure in a patient's right side or in a left orientation for a procedure in a patient's left side. The combination track slidably receives a camera device through the circular opening into the bore and slidably receives a surgical implement through the slot opening and into an action area outside the bore.

Abstract: A surgical access assembly and method of use is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath and obturator are configured to be delivered to an area of interest within the brain. Either the outer sheath or the obturator may be configured to operate with a navigational system to track the location of either within the brain. Once positioned at a desired location, the obturator is removed, leaving a distal end of the outer sheath adjacent an area of interest, and creating a working corridor. Interrogation of the area of interest may be performed to evaluate a disorder and/or abnormality, as well as evaluate treatment regimes. Interventional devices may also be introduced to the area of interest, as well as a variety of treatments.

Abstract: Devices used to deploy transvascular medical device systems and methods for using such devices are described in this document. For example, this document describes dilating introducer devices used for the percutaneous vascular deployment of catheter-based medical devices such as structural heart medical devices. Such dilating introducer devices can facilitate the percutaneous vascular deployment of catheter-based medical devices without an additional introducer sheath.

Abstract: A medical device system may include an elongate shaft having a lumen extending from a proximal end to a distal end, a proximal release wire, and a distal release wire. The proximal release wire may extend distally from a proximal end configured to remain outside the body to a distal end and may be slidably disposed within the lumen of the elongate shaft. The proximal release wire may include a distal stopper coupled to the distal end thereof. The distal release wire may extend distally from a proximal end to a distal end and may be slidably disposed within the lumen of the elongate shaft. The proximal end of the distal release wire may be slidably coupled to the distal end of the proximal release wire. The distal release wire may be configured to releasably attach a medical device to the distal end of the elongate shaft.

Abstract: A transvaginal occluder includes an elongated housing having proximal and distal portions and an internal cavity defined therebetween configured for selective receipt of a surgical instrument therethrough. The elongated housing includes a first material having a first durometer extending between the proximal and distal portions and defining the internal cavity, the first material including one or more recesses defined therein along the internal cavity. The elongated housing also includes a second material having a second, lower durometer and that extends between the proximal and distal portions, the second material encapsulating a portion of the first material and configured to engage vaginal tissue. The elongated housing also includes a third material having a third, lowest durometer disposed within the one or more recesses that is configured to engage a shaft of the surgical instrument in a fluid tight manner.

Abstract: The present application provides external bone fixation systems. The systems include one or more pairs of bone fixation platforms in the form of rings or partial rings. The platforms may be coupled to corresponding bone segments. The pair of platforms are configured to accept a plurality of struts extending therebetween. The struts are configured to attach to the platforms via joints that provide three degrees of rotation. The struts are also configured such that their longitudinal length extending between the joints/platforms can be incrementally adjusted while attached to the platforms. The struts are further configured such that their total range of length adjustment can be increased by coupling at least one add-on component to the struts in situ. The lengths of each of the plurality of struts may be adjusted to arrange the platforms, and thereby the bone segment coupled thereto, in particular relative positions and orientations.

Abstract: A spinal construct includes a body defining a transverse axis. The body includes a wall disposed between a first implant cavity and a second implant cavity. The body further defines a first opening communicating with the first implant cavity and a second opening communicating with the second implant cavity. The first opening defines a first axis and the second opening defines a second axis. At least one of the first axis and the second axis are disposed in a substantially non-perpendicular orientation relative to the transverse axis. Systems, surgical instruments, implants and methods are disclosed.

Abstract: An intra-osseous support structure can be used to fixate opposed portions of bone. In some examples, the intra-osseous support structure is positioned in openings formed in adjacent portions of bones. Fasteners are inserted through the bone portions to secure the intra-osseous support structure in the bones. Depending on the application, one or more external bone plates may also be applied to the bone portions. The external bone plate may be in compression while the intra-osseous support structure is in tension under load in situ.

Abstract: A bone material dispensing system is provided. The bone material dispensing system comprises a loading device having a perimeter surrounding a base plane and a rim, the perimeter comprising a side wall extending along a longitudinal axis and a bar joining the side wall at a corner of the perimeter and extending in a direction transverse to the longitudinal axis, the base plane comprising a loading surface bordered by the side wall along the longitudinal axis, the loading surface having an end edge extending in a direction transverse to the longitudinal axis such that the side wall, the bar and the end edge form a rim adjacent to the loading surface and the bar. A method of loading bone material with the bone material dispensing system is also provided.

Abstract: One aspect relates to a method for providing a bone cement from two starting components, having a hollow cylinder-shaped first container, in which a monomer liquid as first starting component can be stored, a hollow cylinder-shaped second container comprising a container wall, a first internal space, and a second internal space, whereby a bone cement powder as second starting component can be stored in the first internal space, and whereby the monomer liquid can be conveyed into the second internal space, a fluid-conducting conveying means arranged between the first internal space and the second internal space, whereby the first container and the second container are axially connected to each other.

Abstract: Expandable spinal implants, systems and methods are disclosed. An expandable spinal implant may include a first endplate, a second endplate, and a moving mechanism that is operably coupled to the first and second endplates. The moving mechanism may include a wedge, a first sliding frame and a second sliding frame disposed on opposite sides of the wedge, a screw guide housing a rotatable first set screw and a rotatable second set screw opposite the first set screw. The first set screw may be operably coupled to the second sliding frame and the second set screw may be operably coupled to the wedge. The moving mechanism may operably adjust a spacing between the first and second endplates upon simultaneous rotation of the first and second set screws and operably adjust an angle of inclination between the first and second endplates upon translating the first set screw or second set screw.

Abstract: This document describes methods and devices for treating ventricular fibrillation. For example, this document describes methods of performing electroporation of a ventricle and electroporation catheters. The methods can include inserting a distal end portion of a catheter into a ventricle of a heart of a patient, inflating a balloon coupled to the distal end portion of the catheter, occluding a valve of the heart associated with the ventricle with the balloon, injecting a fluid into the ventricle via an aperture defined by the distal end portion of the catheter, and generating an electrical current via an electrode on the distal end portion of the catheter.

Abstract: An electrosurgical handpiece is provided that includes a squeezable handle. The squeezable handle has a back grip and a finger grip that can be squeezed to actuate electrosurgical handpiece. The back grip and the finger grip are connected by a lower malleable region that has an elasticity greater than the remainder of the squeezable handle.

Abstract: The disclosure relates to systems and methods for irrigated bipolar radiofrequency ablation. Some examples of the system include an elongate inner electrode assembly and an elongate outer electrode assembly. An irrigation path for irrigation fluid flow is defined between the outer surface of the inner electrode assembly and the outer surface of the outer electrode assembly.

Abstract: Disclosed embodiments relate to devices, systems, and methods of shaping, shrinking, opening, dilating, stiffening, or otherwise modifying a Eustachian tube and its surrounding tissue in order to improve the Eustachian tube's function. For example, patients with blocked, closed, or hypertrophic Eustachian tubes may be able to achieve improved function including easier equalization of pressure between the inner ear and environment.

Abstract: A controller for an electrosurgical generator includes an RF inverter, a signal processor, a software compensator, a hardware compensator, and an RF inverter controller. The RF inverter generates an electrosurgical waveform and the signal processor outputs a measured value of at least one of a voltage, a current, or power of the electrosurgical waveform. The software compensator generates a desired value for at least one of the voltage, the current, or the power of the electrosurgical waveform, and the hardware compensator generates a phase shift based on the measured value and the desired value. The RF inverter controller generates a pulse-width modulation (PWM) signal based on the phase shift to control the RF inverter.

Abstract: A colpotomy system includes a surgical instrument and a uterine manipulator. The surgical instrument has a shaft assembly. The shaft assembly includes an end effector supported on a distal end portion of the shaft assembly. The end effector includes a first jaw member and a second jaw member. The uterine manipulator extends distally to a head supporting a knife that is positioned to cooperate with the first and second jaw members of the end effector.

Abstract: An end effector assembly for use with an electrosurgical instrument is provided. The electrosurgical instrument includes a handle having a shaft that extends therefrom, an end effector disposed at a distal end of the shaft, at least one electrode operably coupled to the end effector and adapted to couple to a source of electrosurgical energy, a chromium nitride coating covering at least a portion of the electrode, and a hexamethyldisiloxane plasma coating covering at least a portion of the chromium nitride coating.

Abstract: A system for treating uterine tissue comprises an elongated shaft having a proximal end, a distal end, and a longitudinal axis extending between said proximal and distal ends. An energy applicator at the distal end of the elongated shaft is actuatable between a non-expanded shape to be inserted through a patient's cervical canal and an expanded shape to conform to the walls of the patient's uterus. A handle is coupled to a proximal end of the elongated shaft. The handle may include first and second moveable grips coupled to actuate the energy applicator with an upper spring and a lower spring disposed to urge the first and second moveable grips to move apart. An inflatable seal may be located at a distal end of the elongated shaft with a thermally insulating sleeve disposed over the elongated shaft proximal to the inflatable seal.

Abstract: Intra-cardiac voltage data display systems display a plurality of data sets derived at least from intra-cardiac voltage data sampled by an electrode. In some embodiments, at least some of the data sets are derived from a portion of the intra-cardiac voltage data that excludes an excludable portion of the intra-cardiac voltage data having a relationship with an occurrence of a particular cardiac event to facilitate identification of the existence of a transmural lesion in tissue adjacent the electrode. In some embodiments, the particular cardiac event is the occurrence of an R wave in the cardiac cycle, and the excludable portion is a V wave in the cardiac cycle.

Abstract: The present disclosure provides a hair removing device, including: a reflector, a light source, a first light-transmitting body, a heat dissipation base and a refrigerating member. The light source is arranged inside the reflector and can emit light. The reflector can reflect light, such that the hair removing device can emit light to remove the hair from the skin. The first light-transmitting body and the reflector cooperatively define a cavity to receive the light source. A body of the light source is suspended in the cavity. Two sides of the heat dissipation base are thermally coupled to the reflector and the refrigerating member respectively.

Abstract: An electrosurgical instrument capable of performing both thermal ablation and electroporation in a minimally invasive manner. The instrument is dimensioned to fit within an instrument channel of an endoscope to enable non-percutaneous insertion. The instrument comprises a radiating tip mounted at a distal end of a coaxial transmission line to receive microwave EM energy from the coaxial transmission line and emit it as a field around the radiating tip. The instrument further comprises an auxiliary transmission line arranged to convey electromagnetic energy having an electroporation waveform to a microelectrode array mounted on the radiating tip. The electroporation waveform may be a radiofrequency or low frequency electromagnetic (EM) signal. The microelectrode array may comprise a plurality of nanoscale conductive electrode elements.

Abstract: End user interactions at a display are monitored for predetermined conditions to provide augmentation of display presentation by a red light that illuminates in the 650 to 800 nm range, such as at substantially 670 nm. Instructions stored in non-transient memory and executed on a processor present visual images of varied color contrast and evaluate end user inputs to determine an end user visual acuity. Over time and use of the display and red light, end user visual acuity is periodically tested to evaluate the effectiveness of red light illumination to restore visual acuity.

Abstract: Disclosed herein are methods and apparatus for making a determination about an eye comprising detecting light reflected out of an eye of a subject from a retina of the eye of the subject and making a determination about the eye of the subject based upon the reflected light, wherein the light is adjusted for color temperature when making the determination about the eye.

Abstract: A device for visualizing an irido-corneal angle of an eye through a window of a patient interface configured to be placed on the eye includes and optics structure and at least one imaging apparatus. The optics structure is configured to engage with the patient interface to provide a line of sight through the window in the direction of the irido-corneal angle, and to subsequently disengage from the patient interface. The imaging apparatus is associated with the optics structure and aligned with the line of sight to enable capturing an image of the eye including the irido-corneal angle.

Abstract: Disclosed herein are methods and apparatus for making a determination about a cataract in an eye in ambient lighting conditions.

Abstract: Provided are apparatuses, a non-transitory computer-readable medium or media, and methods for supporting predicting of vascular disease using a fundus image of a subject. In certain aspects, disclosed a method including the steps of: extracting a feature information from a first fundus image of the subject based on a machine learning model; generating a second fundus image having a feature which is corresponding to the feature information by mapping a saliency factor to the first fundus image; and displaying the first fundus image and the second fundus image on a display device.

Abstract: Introduced here are retinal cameras having one or more optical components whose position can be modified so that the left and right eyes can be imaged during a single imaging operation. Collectively, the optical component(s) may be referred to as an “optical assembly.” An optical assembly can include the objective lens, lens tube, and other optical components such as mirror(s), light source(s), capturing medium(s), etc. An optical assembly of a retinal camera may be movable between a first position and a second position along an arcuate path. By moving the optical assembly between the first and second positions along the arcuate path, the retinal camera can align the lens tube with the left and right eyes of an individual while clearing her nose. Thus, the retinal camera may generate images of the left and right eyes during an imaging procedure without requiring that the individual move her head.

Abstract: System and method for imaging a target site with a housing assembly having a head unit configured to be at least partially directed towards the target site. An optical coherence tomography (OCT) module and stereoscopic visualization camera are at least partially located in the head unit and configured to obtain a first set and a second of volumetric data of the target site, respectively. A controller is configured to register the first set of volumetric data with the second set of volumetric data to create a third set of registered volumetric data. The third set of registered volumetric data and second set of volumetric data are rendered, via a volumetric render module, to a first and second region. The first region and the second region are overlaid to obtain a composite shared view of the target.

Abstract: Various systems and methods providing recommendations based on analysis of surgical procedure variables are disclosed. A computer system, such as a surgical hub, can be configured to be communicably coupled to a surgical device. The computer system can be programmed to determine contextual data related to the surgical procedure being performed based at least in part of perioperative data received from the surgical device paired with the computer system. Further, the computer system can determine a procedural variable associated with the determined surgical context and then compare the procedural variable to a baseline. Depending upon the outcome of the comparison, the computer system can provide intraoperative or postoperative recommendations to the surgical staff.

Abstract: Certain aspects relate to systems and techniques for navigation path tracing. In one aspect, a system displays a preoperative model of a luminal network is displayed. The system determines a position of an instrument within the luminal network relative to the preoperative model. Based on the position of the instrument relative to the preoperative model, the system determines whether to enter a path tracing mode. In path tracing mode the system displays visual indicia indicative of a path of the instrument with respect to the displayed preoperative model. The visual indicia may be used to visual the navigation path of the instrument and/or to extend the preoperative model.

Abstract: A system and method provide feedback to guide a user to arrange components of a surgical robotic system in a suitable arrangement for the surgical procedure to be performed. An image of a medical procedure site at which a robotic manipulator and a second object such as a second robotic manipulator, patient table, patient, and bedside staff are located. The image is displayed for a user. The system uses computer vision to recognize the robotic manipulator and second object in the image and determine their relative positions. Based on the type of surgical procedure that is to be performed, the system determines a target position for the robotic manipulator and/or the second object, and displays, as an overlay to the displayed image, a graphical indication of the target position.

Abstract: Systems and methods of fluid passageway cross-sectional area determination in an anatomy are disclosed.

Abstract: A detection element and a verification system are disclosed. The detection element includes a detection end for contacting a feature portion of the osteotomy guide tool; and a positioning target connected to the detection end and configured to provide a pose parameter of the feature portion of the osteotomy guide tool in a coordinate system of a trackable element. With this configuration, the osteotomy guide tool can be verified to avoid deformation of the osteotomy guide tool during repeated use or transportation, affecting its positioning accuracy and affecting the operation.

Abstract: A shape sensing enabled instrument includes a flexible guide wire or support rod including an outer surface which encapsulates interior features. The interior features include an optical fiber lumen (105) configured to receive one or more optical fibers for optical shape sensing, and a guide wire support rod or the support rod forming a hollow extending longitudinally along the instrument. The guide wire support rod or the support rod is configured to receive the optical fiber lumen therein to permit rotation and translation of an optical fiber and to protect the optical fiber.

Abstract: A method for actuating an X-ray device during robot-assisted navigation of at least two objects introduced into a body, such as a hollow organ, of a patient by at least one robotic system, includes providing a first selection criterion for selecting one of the objects, and providing a second selection criterion for selecting one of the objects. One of the at least two objects is selected based on the first selection criterion and the second selection criterion, and recording parameters of the X-ray device are automatically set, such that the selected object in an X-ray image to be recorded is highlighted compared to the at least one other object. The selected object may be highlighted with respect to image quality, image flavor, positioning on the X-ray image, and/or a collimator setting of a collimator of the X-ray device. An X-ray image is recorded with the set recording parameters.

Abstract: Surgical systems and methods are disclosed for creating a 3D model of a patient's affected area using an imaging device, using the model to determine an implant orientation and position, creating patient-matched instrumentation, placing the patient-matched instrumentation on the patient's anatomy, registering a computer-assisted surgical tool, and acquiring registration information. The methods and systems also include associating the surgical tool with a computer to perform a computer assisted surgery. Also disclosed are embodiments of patient-matched instrumentation to acquire registration information.

Abstract: A drill guide fixture may be configured to prepare a skull for attachment of a cranial insertion fixture. The drill guide fixture may include a central drill guide and a bone anchor guide at a base of the drill guide fixture. The central drill guide may define a central drill guide hole therethrough, wherein the central drill guide hole has a first opening at a base of the drill guide fixture and a second opening spaced apart from the base of the drill guide fixture. The bone anchor drill guide may define a bone anchor drill guide hole therethrough, and the bone anchor drill guide hole may be offset from the central drill guide hole in a direction that is perpendicular with respect to a direction of the central drill guide hole. Related cranial insertion fixtures, robotic systems, and methods are also discussed.

Abstract: A teleoperated surgical system is provided that includes a surgical instrument that includes an end effector mounted for rotation about a slave pivot axis; a master control input includes a mount member, first and second master grip rotatably secured at the mount member for rotation about a master pivot axis; sensor to produce a sensor signal indicative of a slave grip counter-force about the slave pivot axis; one or more motors to impart a shear force to the mount member, perpendicular to the master pivot axis; one or more processors to convert the sensor signal to motor control signals to cause the motors to impart the feedback shear force to the first and second master grip members.

Abstract: A surgical system comprising: at least two modular units, the modular units each comprising: a surgical arm; and a motor unit configured for actuating movement of the surgical arm, the motor unit configured to be operably attached to the surgical arm, where a first face of a motor unit housing generally defines a plane which is at an angle of 60-120° to a long axis of the surgical arm; wherein the motor unit is configured to be aligned adjacent a motor unit of at least one second modular unit; wherein a second face of a housing of the motor unit generally defines a plane which is at an angle to the first face and which comprises a connection geometry suitable for connecting the housing of the motor unit to a housing of the motor unit of the second modular unit.

Abstract: A medical instrument system comprises an instrument manipulator configured to control a position of a medical instrument with respect to a base. The instrument manipulator comprises an instrument carriage comprising a medical instrument connector configured to engage the medical instrument. The instrument carriage is configured to translate along a linear axis to advance or retract the medical instrument with respect to the base. The medical instrument system also comprises an insertion stage slideably engaged with the instrument carriage along the linear axis. The insertion stage has a drive assembly comprising a drive belt and a drive motor configured to drive the drive belt. The base is fixedly coupled to the drive belt. The medical instrument system also comprises a connecting element having a distal end fixedly coupled to the drive belt and a proximal end fixed to the instrument carriage.