Abstract: A surgical instrument includes a sensor that provides a displacement signal over a first time interval corresponding to a cutting process. The surgical instrument includes a controller to receive the displacement signal and a memory device. The controller determines a preceding velocity-related signal from the displacement signal over a second time interval being a portion of the first time interval. The controller also determines a first acceleration-related signal over a third time interval based on the displacement signal. The third time interval occurs after the second time interval. The controller further determines a preceding velocity factored acceleration-related signal for the third time interval based on the first acceleration-related signal and the preceding velocity-related signal. The controller also determines a breakthrough time of a cutting tool through a cortical wall of a bone based on the preceding velocity factored acceleration-related signal.

Abstract: A surgical tool system is provided. The surgical tool system includes a tool unit including an energy applicator that is actuated by a power generating unit. The surgical tool system also includes a battery and control module including a module housing shaped to receive the tool unit and having a bore that establishes a channel through the module housing, wherein when the tool unit is received by the module housing, the channel extends to the cannulated rotor.

Abstract: Described herein is a method for treating a narrowed region of a lumen in the ear or nose of a patient. The method includes advancing a catheter within the lumen such that a distal end of the catheter is positioned proximate to the narrowed region, filling a fillable member to expand the fillable member within the lumen, and generating at least one shock wave from at least one shock wave emitter. The at least one shock wave creates one or more fractures in a bony structure of the narrowed region of the lumen that dilate the narrowed region.

Abstract: Bone fragment manipulation devices for use at surgical sites are disclosed. These devices include a handle disposed between a first tool component and a second tool component. The second tool component includes an opening for receiving a k-wire. Systems and kits including these devices, as well as methods of production and use thereof, are also disclosed.

Abstract: Joint balancing methods and apparatus for arthroplasty procedures are disclosed. An example apparatus includes a knee arthroplasty set of guides comprising: (a) a femoral guide configured to mount to a distal femur, and (b) a tibial guide configured to mount to a proximal tibia, where the femoral guide and the tibial guide are configured to engage one another and lock in an angle between a longitudinal axis of the distal femur and a longitudinal axis of the proximal tibia of 30-70 degrees.

Abstract: Time domain viscometry is disclosed in the context of a thrombectomy system, wherein the aspirate composition may span saline (?1 cP) and blood (?4 cP) to blood/thrombus mixtures (˜10 cP to ˜10,000 cP) to a clog (>10,000 cP). An objective of a suction thrombectomy system is to aspirate low-viscosity blood at low suction levels concomitantly with aspirating high-viscosity thrombus at high suction levels. Time domain viscometry comprises measuring the time required for fluids of differing viscosities to flow into an elastically deformed conduit. One or more fluid standards (e.g., saline, blood, etc.) may be used for in-situ calibration of the viscometer. Ratiometric analysis of the resulting measurements permits time domain differential viscometry wherein the viscosity of an unknown fluid is determined with respect to a fluid of known viscosity. Viscometric thrombectomy systems are enabled to discriminate between blood and thrombus and adjust the aspiration rate accordingly.

Abstract: A system for dislodging and removing occlusions from a vascular vessel. The system includes a handle and an elongate member, the elongate member including an occlusion dislodging member adapted to axially move, radially expand and contract, and rotate to dislodge vessel occlusions. The handle is adapted to selectively induce the axial movement, radial expansion and contraction, and rotation of the occlusion dislodging member.

Abstract: An aspiration system is disclosed that is configured to capture and aspirate a thrombus flowing within a blood vessel and includes a capture device provided with an expandable capture unit and a capture wire extending from the capture unit, and an aspiration device provided with an aspiration tube and an aspiration port. The capture unit includes a plurality of linear members that is deformable and braided, a distal side coupler that couples distal portions of the plurality of linear members, and a proximal side coupler that couples proximal portions of the plurality of linear members and is coupled to the capture wire. The proximal side coupler includes an inner tube and an outer tube. The inner tube has a proximal portion located closer to the proximal side of the proximal side coupler than a proximal portion of the outer tube.

Abstract: An intraluminal device including an elongated structure formed of a plurality of wires may be provided. The intraluminal device may include a plurality of sets of looped wires longitudinally located at an intermediate area of the elongated structure. The sets of looped wires may be spaced circumferentially about the elongated structure and may be configured to cooperate with each other to form a plurality of clot entry openings. The intraluminal device may also include at least one grouping of woven wires that may be longitudinally located adjacent to the intermediate area and may be configured such that when an opening force is exerted on the elongated structure, the at least one grouping of woven wires may provide structural support to hold open first interstices between the plurality of sets of looped wires.

Abstract: A device for removing a substance from a nasal cavity, the device having a handle; a working tip; and a stopper connected to the working tip, the stopper being operative to limit a depth of insertion of the working tip into the nasal cavity; the distal end of the handle has a working tip engagement feature configured to receive a handle engagement feature of the working tip to connect the working tip and the handle; the working tip includes a stopper engagement section and the stopper includes a working tip engagement section; and the stopper engagement section and the working tip engagement section include a corresponding helical threaded connection so that the stopper is rotatable about the working tip to increase and decrease a distance between the working tip and the stopper.

Abstract: A surgical instrument includes an actuation device. The surgical instrument includes a hollow shaft having a tool at the distal end of the shaft. The tool includes two jaw parts, and the actuation device is operatively connected to an actuation rod mounted in the shaft so as to and move and close the jaw parts. The actuation device includes a cam wheel that is operatively connected to the actuation rod by a connection portion. The actuation device includes a bearing device that provides forced guidance of a cam-follower pin along a longitudinal axis, such that, when the cam wheel is rotated about a rotational axis of the cam wheel, a linear movement of the cam-follower pin, guided in the cam track, and the actuation rod operatively connected thereto is provided along the longitudinal axis.

Abstract: A medical device includes a shaft, an end effector at a distal end of the shaft, the end effector having a first jaw that pivots relative to a second jaw about a pivot axis, a control mechanism engaging a surface of the first jaw, such that when the control mechanism translates relative to the pivot axis from a first state to a second state, the surface of the first jaw moves relative to the control mechanism and pivot about the pivot axis. The medical device further includes an actuator extending through the shaft and coupled to the control mechanism, where translation of the actuator translates the control mechanism from the first state to the second state.

Abstract: Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating one or more abrasive elements within the vessel. The abrasive elements are attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, individual abrasive elements are attached to the drive shaft at differing radial angles in comparison to each other (e.g., configured in a helical array). The centers of mass of the abrasive elements can define a path that spirals around the drive shaft in a direction that is opposite to the wind direction of filars of the drive shaft, and opposite to the direction of rotation.

Abstract: A device support insertable into a sheath, the device support supporting a medical device including a rotatable drive shaft extending from a distal end to a proximal end, and an operation unit that accommodates a drive source connected to the drive shaft, the device support including a plurality of tubular bodies that accommodates the drive shaft and an outer tube, in which a first tubular body disposed on a most proximal end side among the plurality of tubular bodies has a proximal end connection portion connectable to the operation unit at a proximal end portion of the first tubular body, and the plurality of tubular bodies includes at least a second tubular body and a third tubular body having an outer diameter smaller than an inner diameter of the second tubular body, and the second tubular body and the third tubular body are movable relative to one another.

Abstract: A surgical incision apparatus and method for puncturing a cutaneous layer of a subject for providing guided access to a subcutaneous organ or subcutaneous cavity (or specified target region) of the subject. The apparatus may include a retention body configured for securing a cutting tool therein and a housing configured for receiving the retention body. The apparatus includes a guidewire holder member configured for receiving a guidewire therein and aligning with the guidewire to allow the cutting tool to travel along the guidewire. The retention body is configured to be movably attached relative to the housing to allow the retention body and cutting tool to advance toward the subject to a deployed position, and subsequently withdraw to a retracted position.

Abstract: An elongated medical body includes a main body portion extending in an axial direction and including a guide wire lumen through which a guide wire can pass, a shaft portion extending in the axial direction and connected to a proximal end side of the main body portion, and a guide wire port which is provided at a connection point between the main body portion and the shaft portion, and through which the guide wire can enter and exit, and an inner diameter of the guide wire lumen is equal to or larger than an outer diameter of the shaft portion.

Abstract: The present invention relates to a puncture device that is arranged for being advanced to a puncture site through the human vasculature, the puncture device comprising: a puncture means, the puncture means comprising a distal end that is arranged for creating a puncture in a patient's tissue, a sheath, the sheath being arranged so as to surround the puncture means, the puncture means being slidably arranged inside the sheath, a tissue expansion means, the tissue expansion means being arranged so that it can be selectively activated, wherein in the activated state, the tissue expansion means pushes away the patient's tissue to thereby allow a re-orientation of the puncture means.

Abstract: A device for providing access to a nodule, lesion, or pathological area in a lung or other body organ or lumen. The device includes a sheath portion having a proximal end and a distal end and a plurality of stabilization wires. The sheath portion includes a primary lumen that extends from the proximal end to the distal end and a plurality of secondary lumens that extend from the proximal end to the distal end. The stabilization wires are configured to be slidably received within the secondary lumens. The length of the stabilization wires is greater than the length of the secondary lumens.

Abstract: A gas sealed access cap for a robotic cannula is disclosed which includes a housing defining an interior cavity that supports an annular jet assembly for receiving pressurized gas from an inlet port of the housing, wherein the annular jet assembly is adapted to generate a gaseous sealing zone within the robotic cannula to maintain a stable pressure within the surgical cavity of a patient during the performance of a robotically assisted laparoscopic surgical procedure.

Abstract: A pad is provided having a body for providing a gas seal over a surgical site, a port extending between a first surface of the body and a second surface of the body and sized accept a surgical instrument, and a lumen situated along the body and having a first opening and a second opening, the second opening aligned with the surgical site for communicating a fluid flow to the surgical site.

Abstract: An insertion tool for creating a subcutaneous pocket and implanting a device in the pocket. The tool may include a handle, a tunneling tube, a dissector, and an inserter. The dissector may be configured to create the subcutaneous pocket, move from an extended position to a retracted position, and rotate from an operating position disposed on a longitudinal axis of the tunneling tube to an idle position. The insertor including a cannula and configured to hold the device in a passage of the cannula, rotate from an idle position to an operating position disposed on the longitudinal axis of the tunneling tube, and move from a retracted position to an extended position in which the cannula is at least partially within the tunneling tube. The tunneling tube is configured to retract to release the device out of the tunneling tube and deploy the device in the subcutaneous pocket.

Abstract: A safety lancet transseptal access system is disclosed. The system includes a housing having a proximal end and a distal end, the proximal end having an opening with a plunger and the distal end terminating in a housing wall, a housing lumen extending through the housing and a release mechanism coupled to the housing. The system further includes a puncture device spring connected to the plunger and a disk. The system further includes a puncture device connected to the disk. When the plunger is pushed towards the distal end of the housing, the puncture device spring compresses triggering the release mechanism which then causes the puncture device to be deployed past the housing wall. Additionally, once deployed, tension from the puncture device spring pulls the disk and the puncture device back into the housing to a neutral position.

Abstract: Disclosed herein are external fixation frames for correcting bone deformities. The external fixation frames include a top fixation ring and a bottom fixation ring coupled to one another by at least two struts. A half ring is coupled to bottom fixation ring. The bottom fixation ring is u-shaped. One or more rocker members may be coupled to the bottom fixation ring. The half ring may be hingedly coupled to the bottom fixation ring such that it can rotate with respect to the bottom fixation ring from a first position to a second position.

Abstract: A system for coupling a rod to bone includes first and second bone anchors that are different from one another and a coupling device including a receiving part with a central axis and a head receiving portion for interchangeably receiving a head of either the first or second bone anchors, and a pressure member configured to exert pressure on the head of either the first or second bone anchors when the head is in the receiving part to clamp the inserted head at a particular position relative to the receiving part. The coupling device includes a restraining surface configured to cooperate with the first bone anchor to restrict pivoting of the first bone anchor to a single plane. The coupling device is configured to cooperate with the second bone anchor to restrict pivoting of the second bone anchor differently than the restricted pivoting of the first bone anchor.

Abstract: A spinal rod may comprise at least two segments having a constant diameter, where a first segment has a first constant diameter and a second segment has a second constant diameter, and where the first constant diameter is different from the second constant diameter. The spinal rod may also comprise a transition region positioned between the at least two segments, where the transition region has a variable diameter that gradually transitions between the first constant diameter and the second constant diameter, where the transition region comprises a tapered shape, and at least one curve extending along the at least two segments.

Abstract: An implantable receiver may be configured to couple to a bone fastener for spinal fixation. The implantable receiver may include a friction-fit feature to allow the implantable receiver to maintain its orientation before being locked into place by a set screw. For example, the implantable receiver may have a body with an opening extending from the top to the bottom. The receiver may also have a pressure cap disposed within the opening of the body and a retainer ring disposed in a bottom portion the opening. The retainer ring may be expandable around a head of the bone fastener. The friction fit feature may be a compressible coil disposed around the opening of the body above the retainer ring. The compressible coil may be configured to contact the head of the bone fastener and deform to provide a frictional engagement between the head and the body.

Abstract: Systems, methods, and devices for securing a spinal rod are provided. A clamp assembly comprises a tulip comprising an opening comprising an inner surface, wherein the inner surface is threaded; and a threaded locking cap disposed in the opening, wherein threads of the locking cap and the inner surface include various geometries.

Abstract: An adjustable implant includes a body portion including a first end, a second end including a bull nose, and a sidewall extending from the first end to the second end, a hook coupled to the body portion, the hook including a first hook portion extending from the body portion in a first direction, and a second hook portion extending from the first hook portion in a second direction that is different from the first direction, a first wing coupled to the first end of the body portion, and a second wing coupled to the body portion such that the distance between the first wing and the second wing is adjustable by a user, wherein the first and second wings include inward facing surfaces configured to be positioned adjacent portions of bone of a patient.

Abstract: Implants, instruments, and methods for performing surgical procedures on the spine, including one or more of creating an operative corridor to the spine, delivering implants to the spine, fusing one or more segments of the spine, and fixing one or more segments of the spine.

Abstract: In a cluster derotation assembly, a tube clip for joining a locking tube to a link member. The tube clip has a first clip arm and a second clip arm joined to a threaded shaft. One or both of the first clip arm and the second clip arm has an inner surface configured to engage with a complementary surface of a locking tube.

Abstract: A tool for breaking tabs of a vertebral bone anchor can include a tip, a first rail, and a second rail. The tip can be positionable over a housing of a vertebral bone anchor. The first rail can be pivotably coupled to the tip and can extend proximally away from the tip. The first rail can be configured to receive a first extended tab therein. The first rail can be pivotable with respect to the tip between a first upright position and a first outward position to break the first extended tab from the housing. The second rail can be pivotably coupled to the tip and can extend proximally away from the tip.

Abstract: Devices, systems, and methods for bone stabilization, especially volar distal radius stabilization. The stabilization system may include a bone plate having an elongated portion, an enlarged head portion, and a transition region connecting the elongated portion to the enlarged head portion, and the plate including a plurality of through holes. A plurality of fasteners may be configured to extend through one or more of the plurality of through holes in the bone plate and into the bone. The plate may be used to stabilize a fracture in a long bone, such as a radius.

Abstract: A device for dispensing biomaterial includes a handle configured to receive a syringe, the syringe including a biomaterial and a threaded plunger, and an engagement pin retained within the handle and slidable between a first position and a second position. The engagement pin is configured to engage the threaded plunger in the first position, the engagement pin is further configured to disengage from the threaded plunger in the second position.

Abstract: A spine rod cutter including a helicopter socket for engaging a spine rod, and a hole saw coaxial with the helicopter socket for operatively engaging the spine rod.

Abstract: Misaligned bones on opposite sides of a joint are aligned using a first rigid extension securable to one of the misaligned bones using a particular surgical approach, and a second rigid extension having a contacting surface positionable in contact with the other the two misaligned bones from the same surgical approach. The first and second rigid extensions are moved with respect to each other using a lever, whereby a pulling force is exerted on one of the bones, and a pushing force on the other, thereby aligning the first and second misaligned bones.

Abstract: A compression screw driver system including a drive member having a shaft extending from a proximal end to a distal end. A drive selection member is positioned about the shaft and is axially moveable along the shaft between an engagement position and a disengaged position. A distal portion of the drive selection member defines a first engagement structure. A compression sleeve is positioned over the distal end of the shaft. The proximal end of the compression sleeve defines a second engagement structure which complements the first engagement structure and the distal end of the compression sleeve defines a contact surface. In the engagement position the first and second engagement structures are engaged and the compression sleeve rotates with the drive member and in the disengaged position the first and second engagement structures are disengaged and the compression sleeve remains stationary while the drive member rotates.

Abstract: A treatment catheter is part of a system that includes a local impedance indicator that is displayed on a display. The local impedance indicator displays relative changes in impedance to the user in order to quickly communicate information that helps the user better understand where in the heart chamber the catheter is located.

Abstract: A method of directional skin tightening by fractional treatment of the skin is provided. The method includes producing a plurality of excised tissue portions in a region of skin tissue. The method further includes applying contraction or expansion tension to the region of skin tissue in at least one predetermined direction. Applying the contraction or expansion tension to the region of skin tissue promotes collagen growth and provides directional skin tightening in the region of skin tissue.

Abstract: Electrosurgical generator for providing a dual frequency power output in a low and a high frequency range to an output socket for an electrosurgical instrument, including an inverter unit configured to simultaneously generate said dual frequency power output. The inverter unit is a multilevel inverter including a low frequency driving unit configured for forming a low frequency reference signal, a high frequency driving unit configured for forming a HF reference signal, and a modulation unit configured for forming a modulated combined reference signal by modulating the low frequency reference signal onto the high frequency reference signal. The modulated combined reference signal is supplied to the multilevel inverter for generating the dual frequency power output. Thereby, an efficient way for providing high-frequency energy in the low frequency (ultrasound) band as well as the high frequency (radiofrequency) band by means of a single inverter is formed.

Abstract: In an example, a monopolar electrosurgical electrode includes an electrosurgical substrate including an electrically conductive material extending in an axial direction from a proximal end to a distal end. The electrosurgical substrate includes an electrosurgical blade. The electrosurgical blade includes (i) a first lateral surface, (ii) a second lateral surface opposite the first lateral surface, (iii) a first major surface extending between the first lateral surface and the second lateral surface on a first side of the electrosurgical blade, and (iv) a second major surface extending between the first lateral surface and the second lateral surface on a second side of the electrosurgical blade that is opposite the first side. The monopolar electrosurgical electrode also includes a first electrode sensor embedded between a plurality of electrical insulation layers on the first major surface of the electrosurgical blade.

Abstract: An electrosurgical system for radiofrequency ablation. An electrosurgical console includes a processor configured to determine impedance threshold values based on an initial tissue impedance value. The impedance threshold values may vary based on an elapsed time-based characteristic. A temperature set point is reduced based on the occurrence of the impedance event in which a tissue impedance value exceeds a threshold value. The reduced temperature set point may be fixed. The controller is configured to control the delivery of the RF energy drive the tissue temperature to the temperature set point(s). The temperature set point may not be reduced if the impedance event occurs during a ramp period, and an alert may be displayed. Secondary impedance threshold values may be utilized, and slower ramp periods may be provided for later in the ablation procedure. Methods of performing the ablation procedure with the electrosurgical system are also disclosed.

Abstract: A robotic colpotomy system includes a robotic arm, an instrument drive unit supported on the robotic arm, and a uterine manipulator supported on the robotic arm. The uterine manipulator is coupled to the instrument drive unit and has an elongated shaft assembly that supports a colpotomy assembly on a distal end portion thereof. The colpotomy assembly includes a colpotomy cup and extends distally to a distal tip. The various components of the robotic colpotomy system are positioned or movably positioned to help effectuate a colpotomy procedure.

Abstract: An electrosurgical resector tool comprising: an energy conveying structure for carrying radiofrequency electromagnetic energy and/or microwave electromagnetic energy; and, a tool tip mounted at a distal end of the energy conveying structure, wherein the tool tip comprises a first jaw and a second jaw. The first jaw comprises a first pair of electrodes that are electrically isolated. The first pair of electrodes is coupled to the energy conveying structure. The first and second jaw are movable relative to each other between a closed position in which the first and second jaw lie alongside each other, and an open position in which the second jaw is spaced from the first jaw for receiving biological tissue. The first jaw extends in a distal direction beyond the second jaw in the closed position. The first jaw includes a distal end face, the first pair of electrodes being exposed on the distal end face.

Abstract: A system configured to cut leaflet tissue at a cardiac valve may comprise a guide catheter and a cutting mechanism routable through the guide catheter. The cutting mechanism includes a cutting arm and a plurality of grasping arms rotatably coupled to the cutting arm. The grasping arms are connected to the cutting arm via a central hinge and are actuatable between a closed position against the cutting arm and an open position where the grasping arms extend laterally away from the cutting arm by rotating about the hinge. Targeted cardiac leaflet tissue may be grasped between the cutting arm and the grasping arms and cut by a cutting element that is attached to or extends through the cutting arm.

Abstract: A system for use in a transseptal crossing procedure includes an outer cannula having a proximal end, a tapered distal end, a preset curve, and a proximal portion extending between the proximal end and the preset curve. An inner member is configured to slide within the outer cannula between a first position and a second position, the inner member has a stiffness greater than a stiffness of the outer cannula. In the first position the tapered distal end is positioned approximately 90 degrees relative to the proximal portion and in the second position the tapered distal end is positioned greater than 90 degrees relative to the proximal portion. A control mechanism includes a first portion connected to the outer cannula and a second portion connected to the inner member, and is configured to move the inner member between the first position and the second position.

Abstract: Endolumenal devices and methods can be used for the treatment of health conditions involving the different layers of the gastrointestinal tract. For example, this document describes devices and methods for treating diseases involving the gastrointestinal tract by endoscopically delivering pulsed electrical field or electroporation energy.

Abstract: Disclosed herein is an ablation catheter that includes an irrigation conduit, a force sensor, a flexible electrode tip assembly, a seal, and a temperature sensor. The irrigation conduit defines an irrigation lumen configured to carry irrigation fluid to a distal end of the ablation catheter. The force sensor includes a deformable body coupled to the irrigation conduit adjacent a distal end thereof. The flexible electrode tip assembly is coupled to the deformable body and extends distally therefrom, and defines an interior cavity in fluid communication with the irrigation lumen, an exterior cavity in which a distal portion of the deformable body is received, and at least one fluid channel through which irrigation fluid is dispensed from the interior cavity. The seal is disposed between the flexible electrode tip assembly and the deformable body, and the temperature sensor extends through the irrigation lumen and into the flexible electrode tip assembly.

Abstract: Apparatus, having an insertion tube that is configured to be inserted into a body cavity. The apparatus also includes a distal tip connected to the insertion tube, the 5 distal tip having an external surface and a cavity formed in the external surface, the cavity being surrounded by a region of the external surface having a curvature. The apparatus further includes a microelectrode configured to fit into the cavity so that a surface of the microelectrode 10 is contoured, located and oriented to conform with the curvature of the region.

Abstract: According to various embodiments, systems, devices and methods for modulating targeted nerve fibers (e.g., hepatic neuromodulation) are provided. The systems may be configured to access tortuous anatomy of or adjacent hepatic vasculature. The systems may be configured to target nerves within a wall of (e.g., within adventitia surrounding a lumen of) an artery or other blood vessel, such as the common hepatic artery.

Abstract: According to various embodiments, systems, devices and methods for modulating targeted nerve fibers (e.g., hepatic neuromodulation) are provided. The systems may be configured to access tortuous anatomy of or adjacent hepatic vasculature. The systems may be configured to target nerves within a wall of (e.g., within adventitia surrounding a lumen of) an artery or other blood vessel, such as the common hepatic artery.