Abstract: Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.

Abstract: A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

Abstract: Methods and devices for tissue fixation. A cortical button with a rib between two slotted openings. The rib increases the cortical button structural rigidity without increasing palpability. An adjustable loop construct with two discrete locking passages that provides manageable loop reduction and improved tissue coupling. The adjustable loop construct may be coupled to tissue via a passing construct. An assembly with a reduction bar, a button and an adjustable loop construct, the assembly provided assembled in a first configuration that disassembles to guide steps of tissue fixation. The reduction bar may be assembled to the reduction bar for reducing the adjustable loop construct.

Abstract: A suture method includes a first arrangement step of using a first treatment device including first/second grasping pieces to hook the first grasping piece to a first position of peripheral tissues of a lesion; a second arrangement step of hooking the second grasping piece to a second position of the peripheral tissues; a grasping step of grasping the first position and the second position while pressing the first position and the second position to the peripheral tissues; a retracting step of retracting the lesion site toward a proximal end side of the first treatment device while drawing the first position and the second position grasped by the first treatment device; and a suturing step of suturing a first suturing position at an external side of the first position and a second suturing position at an external side of the second position in the peripheral tissues.

Abstract: A suture threader configured to thread sutures through suture holes in a bone plate, including: a base; a plurality of hooks attached to the base, wherein the plurality of hooks are arranged at positions on the base corresponding the suture holes on the bone plate.

Abstract: A releasable elongated assembly includes a release member having a length and an opening that extends along the length. The releasable elongated assembly includes a first elongated element having a first coupling member disposed in the opening and a second elongated element having a second coupling member disposed in the opening opposite the first coupling member along the length. The first and second elongated elements are interlaced with each other in the opening at a location between the first coupling member and the second coupling member such that the first and second elongated elements are attached to each other. The release member is moveable from a first position where the first and second coupling members are captured in the opening to a second position where the first and second coupling members are released from the opening so as to detach the first and second elongated elements from each other.

Abstract: One-piece tissue fasteners are provided for securing two or more tissue layers to each other. Delivery devices are described by which a tandem array of such fasteners can be delivered and deployed to secure tissue layers in a number of locations without requiring removal or reloading of the removal tool.

Abstract: An assembly used in osteosynthesis comprising a delivery instrument in combination with an implant wherein the delivery instrument releasably holds the implant in a first configuration prior to attachment of the implant to bone. The delivery instrument allows the implant to be affixed to bone before the implant is released from the instrument. And the instrument may comprise guide means for drills, depth gauges, screws, pins, pegs, blades and or drivers which are used or implanted when the implant is releasably attached to the instrument. After the implant is affixed to bone and released from the delivery instrument, the implant assumes at least a second configuration which provides compression and or distraction and or control of spatial orientation.

Abstract: A method and apparatus of adaptively controlling a surgical stapling instrument are disclose. The method includes identifying a staple cartridge type, configuring the surgical stapling instrument based on the identified staple cartridge, and adaptively controlling, by a control circuit, operation/functionality of the surgical stapling instrument based on the configuration of the surgical stapling instrument loaded with the identified staple cartridge type. The apparatus includes a control circuit including a microcontroller and a memory coupled to the microcontroller. The memory stores machine executable instructions that when executed by the microcontroller cause the microcontroller to execute the above method.

Abstract: A method for controlling a surgical instrument is disclosed. In at least one instance, the surgical instrument comprises a shroud and the operation of the surgical instrument is modified based on input from a sensing circuit configured to sense a parameter of the shroud. In certain instances, the surgical instrument comprises a strain gage circuit and the operation of the surgical instrument is modified based on input from the strain gage circuit.

Abstract: A piece of buttress material and an end-effector of a surgical instrument including features which can aid a surgeon in properly and quickly attaching the piece of buttress material to the end-effector. In various embodiments, a piece of buttress material can include retention features which can be engaged with portions of an end-effector to releasably retain the piece of buttress material to at least a portion of the end-effector. Similarly, an end-effector can include features configured to engage portions of a piece of buttress material to releasably retain the piece of buttress material to the end-effector. In at least one embodiment, more than one piece of buttress material can be releasably retained to an end-effector.

Abstract: An articulation tool includes proximal and distal links, an elongated shaft therebetween, and first and second locks. Movement of the proximal link about proximal first and second axes causes corresponding movement of the distal link about distal first and second axes. The first and second locks have unlocked configurations in which the proximal and distal links are movable with respect to the elongated shaft about the first axes, or the second axes, respectively, and locked configurations in which the proximal and distal links are held in a fixed orientation with respect to the elongated shaft about the first axes, or the second axes, respectively. Rotation of the elongated shaft while the first and second locks are in the locked configuration and the proximal and distal links are angled with respect to the elongated shaft causes the proximal and distal links to rotate about respective longitudinal axes.

Abstract: A cartridge for use with a surgical instrument includes a curved body and a deck configured to clamp tissue against an anvil. A plurality of staple openings is formed in the deck and is configured to house a plurality of staples. An arcuate slot formed in the deck is configured to slidably receive a cutting member therethrough. An opening formed in the deck adjacent to an end of the arcuate slot is configured to slidably receive a pin therethrough. The cartridge further includes a raised surface offset from the deck and extending circumferentially about at least a portion of the opening. The raised surface is configured to clamp tissue against the anvil to thereby fix the tissue relative to the opening.

Abstract: An instrument can include a shaft with a proximal end portion and a distal end portion, an end effector at the distal end portion of the shaft, and a transmission mechanism at the proximal end portion of the shaft. The transmission mechanism can include a driven input device engageable with an external drive mechanism. The instrument can include an indicator operably coupled to the driven input device and moveable through each of a plurality of consecutive positions, each of the plurality of consecutive positions being associated with a unique indicium of a non-zero number of available uses left of the instrument. In response to the driven input device being driven, the indicator moves from a current position of the plurality of positions to a subsequent position of the plurality of positions. The instrument can also include a device configured to record occurrence of a change in an environmental condition to which the instrument is subjected.

Abstract: A surgical stapling instrument comprising an end effector is disclosed. The end effector comprises an anvil and a cartridge jaw comprising a channel, wherein the channel comprises a lockout recess defined therein. A staple cartridge is replaceably seated in the channel. A firing member is configured to distally advance a sled during a staple firing stroke. The firing member comprises a first portion configured to engage the anvil, a second portion configured to engage the cartridge jaw, and a lockout portion positioned between the first portion and the second portion. The lockout portion is configured to engage the lockout recess when the sled is not in a proximal position prior to the staple firing stroke. The surgical stapling instrument is unable to perform the staple firing stroke when the lockout portion engages the lockout recess.

Abstract: Various systems and methods of controlling a surgical instrument are disclosed. The surgical instrument can include one or more sensors that are configured to detect or measure parameters associated with the use of the instrument and a display. A control circuit can be configured to detect whether the instrument is articulating, firing, clamping, and so on according to relationships between the detected parameters. The control circuit can further cause the display to display an image or sequences of images according to the particular operational state of the instrument. The images can provide alerts, instructions on how to use the instrument, or information detected by the one or more sensors, such as the position of the knife during transection.

Abstract: In various embodiments, a surgical instrument can comprise an end effector including a staple cartridge and a datum portion positioned proximal to the staple cartridge. The surgical instrument can further comprise a shaft and an articulation joint configured to articulate the end effector relative to the shaft. In addition, the surgical instrument can further comprise a firing member configured to deploy a plurality of staples from the staple cartridge and a drive assembly including a drive member configured to move the firing member. The drive assembly may also include a stop configured to engage the datum portion to limit the movement of the drive member after the plurality of staples are fired.

Abstract: A surgical stapling instrument comprising a tissue cutting knife movable through a staple cartridge to perform a staple firing stroke is disclosed. The stapling instrument further comprises a lockout system configured to prevent the tissue cutting knife from being moved through the staple firing stroke if the staple cartridge is missing from the stapling instrument and/or if the staple cartridge has been previously fired. The lockout system comprises a flexible spring that acts on the bottom of the tissue cutting knife at the initiation of the staple firing stroke to push the tissue cutting knife into a lockout recess if the staple cartridge is missing or has been previously fired.

Abstract: A surgical instrument includes a body assembly, a shaft assembly extending distally from the body assembly along a shaft axis, and an end effector at a distal end of the shaft assembly. The shaft assembly includes an outer tube configured to rotate relative to the body assembly about the shaft axis. The surgical instrument further includes a slip ring assembly configured to enable electrical communication between the shaft assembly and the body assembly while permitting relative rotation therebetween. The slip ring assembly includes a first electrical contact supported by the outer tube, and a second electrical contact electrically coupled with the first electrical contact and positioned radially outward of the outer tube. The first electrical contact is configured to rotate with the outer tube about the shaft axis relative to the second electrical contact while the first and second electrical contacts remain electrically coupled.

Abstract: A method of manually operating a surgical tool includes arranging the surgical tool adjacent a patient, the surgical tool including a drive housing having opposing first and second ends, a spline extending between the first and second ends and being rotatably coupled to a drive input at the first end, a drive gear coupled to and rotatable with the spline, a carriage movably mounted to the spline and housing an activating mechanism operatively coupled to the drive gear such that rotation of the spline actuates the activating mechanism, and a bailout mechanism arranged at the second end and including a lever engageable with the spline. The lever is movable relative to the spline to engage the lever allow the lever to be manually rotated to rotate the spline and the drive gear to manually actuate the activating mechanism.

Abstract: An adjunct configured for use with a surgical stapler end effector includes an adjunct body configured to overlie and directly contact a stapling surface of a surgical stapler end effector, and a plurality of resiliently compressible members coupled with the adjunct body. Each resiliently compressible member extends away from the adjunct body in a first plane that intersects the adjunct body and along which the resiliently compressible member is configured to receive a respective staple of the surgical stapler end effector. In response to closure of the surgical stapler end effector, each resiliently compressible member is configured to resiliently compress within the first plane without deforming in a second plane that perpendicularly intersects the first plane.

Abstract: A gastrointestinal tissue approximation clip (“GI TAC”) system for approximating tissue defects, the GI TAC system including an applicator that is sized to travel through an instrument channel of an endoscope; a plurality of tissue approximation clips that are transported to a plurality of locations about a tissue defect by the applicator; a suture coupled to at least one of the tissue approximation clips; and a clip approximation means for approximating the tissue approximation clips. The clip approximation means and the tissue approximation clips are sized respectively to travel through the instrument channel, and the tissue approximation clips are adapted to be detachably coupled to the applicator.

Abstract: A detachable motor-powered surgical instrument. The instrument may include a housing that includes at least one engagement member for removably attaching the housing to an actuator arrangement. A motor is supported within the housing for supplying actuation motions to various portions of a surgical end effector coupled to the housing. The housing may include a contact arrangement that is configured to permit power to be supplied to the motor only when the housing is operably attached to the actuator arrangement.

Abstract: Methods and apparatus for creating an anastomosis or fistula between the gallbladder and an adjacent organ are disclosed. First, a parent magnet, typically a permanent magnet, is deployed in the stomach, small intestine, or another organ adjacent to the gallbladder, and a mating daughter material is deployed in the gallbladder in order to create a magnet-compression anastomosis. The gallbladder may then be ablated or otherwise functionally inactivated through the anastomosis. Another aspect of the invention relates to an all-in-one surgical kit that contains all the necessary specialized tools for a surgeon to perform the procedure.

Abstract: An anastomotic coupler is provided. A ring can include a plurality of receiving portions. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. The ring is aligned with the cartridge such that the receiving portions are aligned with the fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure and are received by the receiving portions such that the tubular structure is coupled with the ring.

Abstract: A surgical instrument includes a stapling assembly and an anvil that releasably couple together to compress and staple tissue. The stapling assembly includes a body having a longitudinal axis, a deck member, and a knife member surrounding the longitudinal axis. The deck member includes a deck surface having an imaginary centerline that surrounds the longitudinal axis, a first deck surface portion extending along a first angular range of the deck surface about the longitudinal axis, and a second deck surface portion extending along a second angular range of the deck surface about the longitudinal axis. A first array of staple openings is disposed on the first deck surface portion and is arranged in a first orientation relative to the deck surface centerline. A second array of staple openings is disposed on the second deck surface portion and is arranged in a second orientation relative to the deck surface centerline.

Abstract: A surgical device controls fluid flow through a vessel by releasable constriction of the vessel using a compressible “C”-shape operating member with first and second elongate flexible members respectively configured to form a first loop and a second loop, the first and second loops intersecting to define an eye surrounding the vessel, wherein the operating member has first and second arms separated by a gap, the first arm being attachable to the first elongate flexible member, the second arm being attachable to the second elongate flexible member, so as to apply tension to the first and second elongate flexible members, the eye being located in the gap, whereby compression of the operating member relaxes tension in the elongate flexible members permitting opening of the eye and fluid flow within the vessel.

Abstract: An occlusion clip comprising: (a) a spring; (b) a first runner including a first open top and a first open end adjacent the first open top, the first runner including a first interior camming surface partially delineating a first interior cavity that is open by way of the first open top and the first open end; (c) a second runner including a second open top and a second open end adjacent the second open top, the second runner including a second interior camming surface partially delineating a second interior cavity that is open by way of the second open top and the second open end, where the spring is configured to be coupled to the first runner and the second runner, where the first interior cavity is configured to receive a first portion of the spring, where the second interior cavity is configured to receive a second portion of the spring, where the first camming surface is configured to engage a first cam of the spring, and where the second camming surface is configured to engage a second cam of the sprin

Abstract: An occlusion clip comprising: (a) a spring; (b) a first runner including a first open top and a first open end adjacent the first open top, the first runner including a first interior camming surface partially delineating a first interior cavity that is open by way of the first open top and the first open end; (c) a second runner including a second open top and a second open end adjacent the second open top, the second runner including a second interior camming surface partially delineating a second interior cavity that is open by way of the second open top and the second open end, where the spring is configured to be coupled to the first runner and the second runner, where the first interior cavity is configured to receive a first portion of the spring, where the second interior cavity is configured to receive a second portion of the spring, where the first camming surface is configured to engage a first cam of the spring, and where the second camming surface is configured to engage a second cam of the sprin

Abstract: An embolic implant includes a detachment feature configured to engage and be released from a delivery member's engagement system. The engagement system can include a loop wire extending through an opening of the detachment feature a pull wire extending through the loop wire to secure the detachment feature to a delivery tube of the delivery member. The detachment feature can include a distal extension configured to engage a distal end of the pull wire to inhibit the pull wire from moving distally into the implant. The detachment feature can also include a sleeve to align the pull wire to the distal extension and/or provide a friction force against the pull wire to inhibit longitudinal movement of the distal end of the pull wire.

Abstract: A surgical clip for simultaneously cutting a blood vessel and controlling bleeding, includes two legs, each including a flat surface and a cutting surface, and a curved section configured to join the two legs. An applicator for installing a surgical clip that simultaneously divides a blood vessel and controls bleeding, includes two jaws that simultaneously hold two surgical clips, and two handles that cause the two jaws to exert a deforming force on the two surgical clips.

Abstract: A surgical clip may include first and second leg members, each having inner surfaces. The inner surface of the first leg member may be concave and the inner surface of the second leg member may be convex. The surgical clip may include a first locking member positioned on a distal end portion of the first leg member, and a second locking member positioned on a distal end portion of the second leg member. The surgical clip may also include a third locking member position between a proximal end portion and the distal end portion of the first leg member, and a fourth locking member positioned between a proximal end portion and the distal end portion of the second leg member. The first and second locking members, and the third and fourth locking members may be configured to interact to secure the surgical clip in a closed configuration.

Abstract: A method includes positioning a surgical tool with an end effector adjacent a surgical site, the end effector including a housing having a tapered section that defines an inner surface, first and second arcuate jaw members protruding distally from the housing and defining a channel therebetween, each arcuate jaw member exhibiting a curved profile shaped to receive an arcuate surgical clip, and a feedbar movable within the housing. The method further including urging the arcuate surgical clip against the inner surface, advancing the feedbar within the housing to engage and follow the inner surface and thereby flexing the feedbar downward and into engagement with the arcuate surgical clip, advancing the arcuate surgical clip with the feedbar into interposition between the first and second arcuate jaw members, and collapsing the first and second arcuate jaw members to crimp the arcuate surgical clip.

Abstract: This is a device, belonging to the medical and hospital artifacts industry, developed to accelerate the hemostatic process for patients undergoing radial punctures, partially compressing the artery subjected to treatment; said cryo-hemostatic device is essentially presented in the form of a wristband (1), providing end bands (2) providing velcro-based closing, interconnected by an intermediate band (3) below which a first cryogenic reservoir pad is located (4), which can be filled with a saline substance by the action of a syringe connected to the first connection nipple (5) attached to the first tube (6), flanked by the second external reservoir pad (7), also provided with a second connection nipple (8), attached to the second tube (9).

Abstract: The present disclosure relates generally to orthopaedic surgical tools used to cut and/or resect a bone of a patient during an orthopaedic surgical procedure such as, for example, a joint replacement procedure.

Abstract: A surgical blade having an attachment base positioned at a proximal end and a wedge-shaped blade. The wedge-shaped blade includes a cutting tip having a first plurality of cutting teeth, which define a cutting edge along the distal end for starting an osteotomy. The wedge-shaped blade includes a second plurality of teeth positioned along rows. Each row is positioned at offset planes from adjacent rows along the wedge-shaped blade.

Abstract: Endoscopic image analysis, endoscopic procedure analysis, and/or component control systems, methods and techniques are disclosed that can analyze images of an endoscopic system and/or affect an endoscopic system to enhance operation, user and patient experience, and usability of image data and other case data.

Abstract: A medical instrument fashioned as an articulating curette for decorticating vertebral endplates of vertebrae of a spine via a cannula has a handle, a controller connected to the handle, two opposing arms extending from the controller, a control shaft between the two opposing arms and coupled to the controller for longitudinally axial movement thereof by the controller relative to the two opposing arms, a bladed decorticating head for decorticating vertebral endplate bone material from vertebral endplates and pivotally connected to the two opposing arms for articulation from 0° to 90° relative to the longitudinal axis of the control shaft, and a pivot mechanism between the bladed decorticating head and the control shaft providing controlled articulation of the bladed decorticating head through longitudinally axial movement of the control shaft. Rotational movement of the controller moves the control shaft axially relative to the two opposing arms to articulate the bladed decorticating head.

Abstract: A system for performing a minimally invasive interventional fusion procedure on a sacroiliac joint of a patient. The system may include a disposable sterile packed implant and kit including access, bone cutting, accessory and extraction instruments.

Abstract: A device for removing clot from a blood vessel includes a shaft. An expandable framework of struts is fixedly coupled to a distal region of the shaft. The struts can be radially expandable from a first to a second radially expanded state in a deployed configuration. An actuation cable can be connected to a plurality of connections of the engaging framework of struts to apply an expansion force, by the struts, as the struts are actuated by the actuation cable from the first radially expanded state to the second radially expanded state. In the first radially expanded state, a distal end of the struts is spaced a first axial distance away from the shaft, and wherein in the second radially expanded state, a distal end of the struts is spaced a second axial distance, different than the first axial distance, away from the shaft.

Abstract: A platform of devices for removing obstructions and other objects within a blood vessel or other interior lumen of an animal is provided. The system may be deployed in the lumen from a catheter(s) and the system includes a proximal hub, and a distal basket comprised of a plurality of cells. A number of different baskets designs are disclosed. Methods of manufacturing such baskets out of a single tube of a memory metal without the need for any welding, and methods of use are also disclosed.

Abstract: Methods and apparatus for evaluating and manipulating objects in a body, for example emboli in a body lumen are described, and in some examples methods and apparatus use adaptable tips on catheters, for example aspiration catheters, for manipulating and/or removing such emboli.

Abstract: A rongeur cutting system and method of operating said system. The rongeur cutting system may comprise a cutting unit that includes an outer tube and a cutting implement capable of both oscillation and longitudinal movement within the outer tube. The rongeur cutting system may also comprise a handpiece including a power source and spindle for actuating the cutting implement. The method of operating the rongeur cutting system may comprise operating the rongeur cutting system in a manual mode and/or operating the rongeur cutting system in a power mode. The manual mode includes moving the cutting implement longitudinally within the outer tube to manually cut tissue without utilizing the power source, and the power mode includes actuating a motor to manipulate the cutting implement within the outer tube while moving the cutting implement longitudinally within the cutting tube.

Abstract: An ultrasonic surgical instrument includes an end effector, a shaft assembly, and a waveguide grounding feature. The end effector includes an ultrasonic blade and a clamp arm movable between an open position and a closed position. The shaft assembly includes a proximal shaft portion extending along a longitudinal axis, an acoustic waveguide extending proximally from the ultrasonic blade, a distal shaft portion extending along a distal axis, and an articulation section interposed between the proximal shaft portion and the distal shaft portion. The articulation section can deflect the distal shaft portion and the end effector relative to the longitudinal axis between a straight configuration and an articulated configuration. The waveguide grounding feature inhibits the ultrasonic blade from shifting relative to the clamp arm along the distal axis as the end effector is driven between the straight configuration and the articulated configuration.

Abstract: A surgical instrument includes an end effector, a shaft assembly, a carrier, and a support structure. Shaft assembly extends proximally from the end effector. The shaft assembly defines a longitudinal axis. The carrier is configured to translate the end effector along the longitudinal axis. The carrier includes a carriage, an actuation driver, and an actuation assembly. The actuation driver is configured to rotate along an axis parallel to the longitudinal axis. The actuation assembly is operatively coupled with the actuation driver and the carriage. The support structure includes a supporting portion. The supporting portion is configured to reduce torsional forces exerted on the carriage as the actuation assembly transfers the rotation of the actuation driver into translation of a portion of the shaft assembly to actuate the end effector.

Abstract: An ultrasonic surgical system is disclosed comprising a surgical instrument and a wrench assembly. The surgical instrument comprises a handle assembly and a body member pivotably coupled to the handle assembly. The handle assembly comprises a first finger grip, an ultrasonic blade, and a waveguide extending proximally from the ultrasonic blade. The body member comprises a second finger grip, a clamp arm movable relative to the ultrasonic blade to capture tissue therebetween, a first body surface defined on a first side of the body member, and a second body surface defined on a second side of the body member. The wrench assembly comprises a wrench and an adapter operably coupled to the wrench. The adapter comprises a first wrench surface configured to engage the first body surface and a second wrench surface configured to engage the second body surface.

Abstract: Methods and apparatus for end effector control and calibration are described. The method may include detecting a signal in response to movement of a first tube relative to a second tube, the first tube driving movement of a clamp arm of the end effector. The method may further include determining a clamp arm position of the end effector relative to a ultrasonic blade of the end effector based on the signal. The method may also include adjusting a power output to the ultrasonic blade of the end effector based on the clamp arm position.

Abstract: For improving the quality of grated tissue, a method is presented for mechanically disintegrating tissue (2) into micrografts, in which method a blade part (3), which has a planar grater surface (3.1), and the tissue placed in a tissue holder are made to move relative to each other, and where the tissue is guided against the grater surface (3.1), characterised in that the tissue is guided against the grater surface (3.1) together with the tissue feeder piece so that the feeder piece (12) is disintegrated together with the tissue (2). The application also includes independent claims concerning an apparatus for mechanically disintegrating tissue into micrografts, and a feeder piece.

Abstract: A therapeutic device, therapeutic system and therapeutic method for myocardium repair, wherein the therapeutic device comprises a treatment needle for piercing the heart to release a therapeutant. The treatment needle includes a needle body (5a), the interior of the needle body (5) has a therapeutant conveying cavity, an end of the needle body (5a) is a needle (5b) which can pierce the myocardium and guide the needle body (5a) to pass through the myocardium, and the needle (5b) has a therapeutant output port which is connected to the therapeutant conveying cavity. The therapeutic device enters into the myocardium in a minimally invasive manner to release the therapeutant to the vicinity of the lesion to improve myocardial function or activity and prevent further deterioration of the disease.

Abstract: A device is described for marking a path on a skin surface for inserting an epidural needle into an epidural space. The device includes a first arm having one or more holes spaced apart along the length of the first arm. A pin is attached at the proximal end of the first arm. A second arm has a proximal end attached to the pin allowing the first and second arms to rotate about the pin to adjust an angle separating the first and second arms. The second arm has one or more holes spaced apart along the length of the second arm. The holes on the first and second arms provide locations for marking the path on the skin surface to insert the epidural needle.