Abstract: A system is provided which includes a cannula and a secondary device. The cannula includes an expandable member, a cannula lumen, and a cannula proximal end. The expandable member includes a proximal most end, a distal most end, at least two movable sections, with the space between the at least two moveable sections, and an impermeable membrane extending across the space between each of the at least two moveable sections. In addition, the impermeable membrane extends from the expandable member distal most end to the expandable member proximal most end. The secondary device is configured to be coaxially placed through the cannula lumen. The cannula proximal end is configured to operatively couple to a vacuum source configured to create a negative pressure to pull an undesirable material into the cannula lumen.

Abstract: A microcatheter system for crossing total occlusions including a distal crosser unit and an actuator is disclosed. The distal crosser unit comprises: a microcatheter having a guidewire lumen; a guidewire present in the guidewire lumen and extending beyond the distal end of the microcatheter; a proximal balloon attached to both the microcatheter and the guidewire, wherein the proximal balloon is configured to longitudinally expand; and a distal anchor member present on the guidewire. And the actuator is configured to sequentially inflate and deflate the proximal balloon such that the distal crosser unit progressively moves across a chronic total occlusion.

Abstract: Various embodiments of the systems, methods and devices are provided comprising angioplasty to break up calcification or other tissue in occlusive areas within a blood vessel. The various embodiments disclosed comprise pressure pulse periods designed to break up calcified occlusive material through a cyclically stretching of the vessel walls without damaging the vessel wall tissue.

Abstract: Various embodiments of the systems, methods and devices are provided comprising angioplasty to break up calcification or other tissue in occlusive areas within a blood vessel. The various embodiments disclosed comprise pressure pulse periods designed to break up calcified occlusive material through a cyclically stretching of the vessel walls without damaging the vessel wall tissue.

Abstract: Systems, devices and methods for removing a blood clot (10) from a blood vessel (12). Various uses of suction pressure and positive pressure, proximal and/or distal to the blood clot (10) assist with clot dislodgement and removal. The pressure(s) may be constant and/or cycled/pulsed to assist with clot dislodgement and/or removal. Various further devices assist with separating the clot (10) from the vessel (12).

Abstract: An apparatus includes an elongate shaft and a position sensor. The elongate shaft defines a longitudinal axis. The elongate shaft includes a distal end, an opening, and a lumen. The position sensor is laterally offset from the longitudinal axis. The first position sensor is fixedly secured relative to the elongate shaft at a known distance from the opening. The first position sensor is configured to generate signals indicating a position of the elongate shaft in three-dimensional space.

Abstract: A forceps device includes grasping portions, a support holding the grasping portions, a first rotating shaft that turnably supports the support, a base member that holds the first rotating shaft, first wires that transmit driving forces to move the grasping portions, first guide pulleys arranged coaxially with the first rotating shaft, the first wires running over the first guide pulleys, respectively, and second guide pulleys arranged upstream of the first guide pulleys, the first wires running over the second guide pulleys, respectively. The second guide pulleys are shifted toward one side relative to a position immediately below the first guide pulleys when the first rotating shaft is viewed in front in an axial direction in a state in which a leading end of the grasping portions points upward, and arranged so that a winding angles ? of the first wires respectively around the first guide pulleys are 65° or larger.

Abstract: A forceps device includes grasping portions, a support that holds the grasping portions, a first rotating shaft that turnably supports the support, a base member that holds the first rotating shaft, first wires that transmit driving forces to move the grasping portions, second wires that transmit a driving force to turn the support about the first rotating shaft, and a stopper that prevents the support from touching the first wires.

Abstract: A forceps device includes a grasping part, a support that holds the grasping part, a bearing mounted in a hole extending through the support, a first rotating shaft that is inserted in the bearing and turnably supports the support, a base member that holds the first rotating shaft, grasping-portion wires that transmit driving forces to move the grasping part, a support wire that transmits a driving force to turn the support about the first rotating shaft, first guide pulleys arranged coaxially with the first rotating shaft, the grasping-portion wires running over the first guide pulleys, and a support pulley formed as part of the support coaxially with the first rotating shaft, the support wire running over the support pulley.

Abstract: A gearbox assembly for a surgical instrument includes an articulation sub-assembly and a jaw drive sub-assembly. The articulation sub-assembly is configured to articulate an end effector of the surgical instrument and the jaw drive sub-assembly is configured to move jaw members of the end effector between an open and closed position. The articulation sub-assembly includes two input shafts, a proximal plate, a middle plate, two center gears, and four lead screws with four nuts. The jaw drive sub-assembly includes a drive rod coupled to at least one of the jaws and a spring force assembly to maintain a force between the jaws.

Abstract: An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.

Abstract: Systems and apparatuses for Transcatheter Aortic Valve Replacement (TAVR) that include a catheter configured at a distal end with a guidewire to deploy the catheter within a vessel lumen to a situs of an aortic valve for leaflet resection; an accessory tool configured with a set of grasping elements attached at a catheter's distal end to enable the accessory tool to travel down the vessel lumen to the situs of the aortic valve to exert a pulling action, to draw an aortic valve leaflet in a direction towards the catheter's distal end and to draw a portion of the aortic valve leaflet into a protective sleeve of the catheter at the catheter's distal end; and a cutting sheath catheter configured at the catheter's distal end to resect tissue that includes a portion of the aortic valve leaflet drawn into the protective sleeve at the catheter's distal end.

Abstract: The present application provides a preoperative detection method and a postoperative detection method for neuromapping, comprising releasing an electrical signal towards the renal artery blood vessel on one lateral side of the body of the patient by the electrode element; monitoring a heart rate by an electrocardiogram monitoring module, and monitoring a blood pressure change in said another renal artery blood vessel on the other lateral side of the body of the patient by the pressure sensor, and determining a nerve activity degree of the patient by judging whether the heart rate and the blood pressure change reach certain thresholds and making determinations in relation to the nerve activity degree so as to screen out the patients with an overactive sympathetic nerve, and a surgical effect of a denervation surgery can also be evaluated before or after the surgery, and can be used to determine whether to perform an ultrasonic ablation again.

Abstract: An apparatus includes a shaft assembly and an end effector. The shaft assembly includes an acoustic waveguide that is configured to transmit ultrasonic vibrations. The acoustic waveguide has a distal nodal flange. The shaft assembly further includes a distal portion bearing radially inwardly against the distal nodal flange. The distal portion cooperates with the distal nodal flange to prevent rotational movement of the distal nodal flange relative to the distal portion and to prevent longitudinal movement of the distal nodal flange relative to the distal portion. The end effector is at a distal end of the shaft assembly. The end effector includes an ultrasonic blade and a clamp arm. The ultrasonic blade is positioned at a distal end of the acoustic waveguide. The clamp arm is operable to pivot toward and away from the ultrasonic blade.

Abstract: An energy treatment device includes a sheath including a hollow portion, a fixed handle provided at a proximal end of the sheath, a probe provided in the hollow portion, a movable handle including a jaw having a recessed portion along a rotation axis of the movable handle extending in a direction orthogonal to the central axis, a metal member provided at a position including the rotation axis, and a preventing member which prevents the metal member from falling out from its position. The sheath extends along a central axis of the energy treatment device and includes an attaching portion by which the movable handle is attached to a position offset from the central axis, the metal member is provided around the rotation axis such that the jaw is rotatable with respect to the sheath, and the prevention member is fixed to the recessed portion.

Abstract: A stoma instrument and a stoma method. The stoma instrument includes a first tube body, a second tube body, a third tube body, a grasping member, a puncturing member, and a cutting member. One end of the first tube body is provided with a receiving opening for receiving a biological tissue. The second tube body is movably arranged inside the first tube body. The third tube body is movably arranged inside the second tube body. The grasping member is used for radially contracting into the second tube body after deformation to follow the second tube body to pass through the biological tissue, and for radially expanding and moving, after the grasping member passes through the biological tissue and leaves the second tube body, towards the first tube body to grasp the biological tissue into the receiving opening. The cutting member is used for cutting the biological tissue at the receiving opening.

Abstract: An instrument with an improved knife unit includes a flat knife arranged in a knife housing. The latter comprises a channel configured for locating the knife therein, wherein on the walls of the channel inwardly projecting projections are formed, preferably in the form of nubs, between which knife is held with play. If knife housing is made of plastic, the projections can be created in a simple manner during primary shaping. If the knife housing is made from a semi-finished product, such as a sheet part by a deformation method, for example by a stamp-bending process, the projections facing one another constricting the channel can be produced in that the walls are provided with cavities on their outer sides. The knife unit is particularly robust against contamination.

Abstract: The disclosure provides systems, methods, and devices for making attachments to soft tissue. The soft tissue attachment system uses tools that have elongated shafts useful in arthroscopic or keyhole surgeries. In the soft tissue system, a tool is taken to the site once and used to both make the hole into the tissue and simultaneously carry the anchor into the hole that is being made.

Abstract: A needle guidance device having a longitudinal axis includes a guide base configured to releasably attach to an ultrasound probe. The guide base includes a platform. A guide tower is fixedly coupled to the guide base. The guide tower extends distally from a distal end of the guide base along the longitudinal axis and extends perpendicularly with respect to the longitudinal axis from the platform. The guide tower includes a plurality of attachment positions. An introducer holder is removably and pivotably coupled to the guide tower at a first attachment position of the plurality of attachment positions.

Abstract: A kink-resistant and/or deformation-resistant flexible tubular elongate member capable of being retroflexed greater than 90°, such as greater than 180°, without one or more lumens therethrough kinking, deforming, distorting, ovalizing, elongating, or otherwise changing shape and/or otherwise being affected functionally.

Abstract: Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

Abstract: A trocar for use with a surgical instrument. The trocar including; a proximal trocar head; a trocar shaft arranged on the trocar head, the trocar shaft is configured to receive an elongated shaft of the surgical instrument, and a positioning device provided on the proximal trocar head and being movable between retracted and extracted states relative to the trocar head, the positioning device being configured to position a distal end of the elongated shaft of the surgical instrument outside the trocar head in the extracted position.

Abstract: A system for delivering medication through a medical device including a passage formed in a body of the medical device, the medical device including an interior defined within the passage and an exterior in fluid communication with the interior, the passage having an inlet and an outlet in fluid communication with the inlet, wherein the passage is configured to fluidly couple a material to a portion of a patient in need of medical treatment.

Abstract: Methods of ablating a basivertebral nerve (BVN) in a lumbar or sacral vertebral body of a patient. An introducer and one or more instruments are selected after a pre-surgical evaluation. The introducer has a handle coupled to a shaft defining a central channel and an opening at a distal tip thereof. The introducer is inserted through a pedicle of the vertebral body such that its opening reaches a cancellous portion of the vertebral body. The one or more instruments are delivered through the central channel. A distal deflectable section of the one or more instruments is advanced past the introducer's opening to position it proximate to the BVN in a posterior midline section of the vertebral body. An active element is extended relative to at least a portion of the one or more instruments. Energy is delivered to the active element to ablate at least a portion of the BVN.

Abstract: Methods and devices are provided for the alleviation of pain during childbirth. Generally, the methods and devices are designed to apply pressure to the hips of a female during the labor process. These devices may be manually or automatically actuated to provide pressure to the hips of a patient and the devices may further include force limiting devices to ensure that excessive forces are not applied to the patient.

Abstract: An improved external fixator assembly for fixating fractures that includes a proximal frame assembly, a distal frame assembly and a polyaxial joint. The polyaxial joint comprises articulating components that engage to have multi-axial or polyaxial translational motion to allow for distraction/reduction and adjustment of flexion/extension, radial/ulnar deviation, pronation/supination of the wrist to an optimal wrist position. The polyaxial joint may be lockable. Fixation screws are also provided for engaging the patient's bone tissue on opposite sides of a fracture.

Abstract: A coupling device for coupling a bone anchor to a rod includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for holding a head of a bone anchor, a pressure member having a first portion for holding and clamping the head and a deformable portion with a free end, and a locking member. The pressure member is expandable for inserting the head and adjustable to lock the head. When the deformable portion is at a first configuration, the free end of the deformable portion is supported by the receiving part, and at least part of the locking member is movable to exert a force on the deformable portion for adjusting the deformable portion to a second configuration where at least part of the deformable portion is farther away from the longitudinal axis compared to the first configuration.

Abstract: A coupling device for coupling a rod to a bone anchor includes a receiving part having first and second ends, a central axis, and two legs defining a recess at the first end for receiving the rod, a pressure member configured to exert pressure on an inserted head, and an actuating member with an engagement surface configured to engage the pressure member. When a first portion of the actuating member moves axially in a first direction, the engagement surface is configured to move from a first axial position to a second axial position to adjust the pressure member from a non-locking position where the head is pivotable to a locking position where the head is locked. When a second portion of the actuating member moves in the first direction, the pressure member is adjusted from the locking position back to the non-locking position.

Abstract: A pivotal bone anchor assembly includes a receiver with an upper channel for receiving a rod and a central bore extending downward through the channel having a support surface adjacent a bottom opening, a guide and advancement structure adjacent the top of the receiver, and a downward-facing surface below the guide and advancement structure. The assembly also includes a shank with a head portion pivotably supported by the support surface with the shank extending downwardly through the bottom opening, and an insert with a lower surface engageable with the head portion of the shank, an insert channel for receiving the rod, an upward-facing surface located radially outward from the insert channel, and one or more slots configured to make the insert resiliently axially compressible when the upward-facing surface of the insert abuts the downward-facing surface of the central bore to apply a downwardly directed pressure against the head portion of the shank.

Abstract: Disclosed herein are integrally formed medical devices and methods relating thereto. One embodiment provides an integrally formed medical device comprising: a substantially trapezoidal body portion having at least one surface that is contoured to fit an anatomy of a patient; and a graft window defining a vertical aperture through said body portion, such that said body portion defines a cage.

Abstract: An instrument for use in surgery includes a hollow shaft connectable to a drive shaft of a bone anchor insertion device in a rotationally fixed manner, a needle holder configured to hold a needle and movable axially relative to the hollow shaft, an actuator rotatable relative to the hollow shaft, and a transmission member connectable to the needle holder and movable axially relative to the actuator. The transmission member is positionable around at least part of the hollow shaft and includes a first advancement surface engageable with a second advancement surface of the hollow shaft to convert a rotational movement of the actuator into axial movement of the needle holder relative to the hollow shaft for axially advancing and retracting the needle held by the needle holder.

Abstract: One aspect of the disclosure relates to an aspect of the disclosure relates to an adjustable implant including: a housing; a first adjustable member at least partially positioned within the housing and moveable relative to the housing; and a first actuation assembly positioned within the first adjustable member and configured to move the first adjustable member relative to the housing.

Abstract: The present invention relates to a device and system for fixation of intra-articular and extra-articular fractures and non-unions of small bones and other small bone fragments, and more particularly to a threaded nail with a robust length and a trailing end with a cutting tip and longitudinal cutting flutes and a stepped diameter with cutting flutes at the transition point, and an optional cannulation along the central longitudinal axis of the nail.

Abstract: A cerclage cable system is disclosed which includes a bone plate, one or more securing devices, and one or more cerclage cables. The bone plate includes a plurality of bone plate apertures thereupon, wherein the bone plate is configured to be affixed to a bone. The one or more securing devices include a body having a proximal end and a distal end, wherein at least one securing device aperture is disposed toward the proximal end, wherein the distal end of the securing device is configured to be inserted into and received by the plurality of bone plate apertures. The one or more cerclage cables include two terminal ends, wherein the one or more cerclage cables are wrapped around the bone, wherein one terminal end of the one or more cerclage cables is passed through at least one securing device aperture.

Abstract: The present invention relates to an apparatus and method for correcting misalignments of the paw in the foreleg of dogs and other animals. The realignment of the paw is intended to properly align the medial compartment of the elbow with the end of the humerus.

Abstract: Systems, apparatuses and methods for bone fusion are disclosed. In particular, a fixation screw assembly is provided that comprises a bone engagement portion including a shaft and a head member. The assembly also includes a flexible washer member that can be operably attached and secured around the head member of the bone engagement portion. The washer member is polyaxial relative to the bone engagement portion, such that it can assume a variety of angles. The washer member can help prevent back out of the bone engagement portion when the bone engagement portion is implanted into a bone member. The design of the fixation screw assembly can be used in different fusion procedures, including fusion of the sacroiliac joint.

Abstract: A device for dispensing bone cement by means of a machine, comprising a connection unit configured for connection to a surgical robot, a press-out unit configured for dispensing bone cement, a receiving unit configured for receiving a container containing bone cement, and an interface configured for connection to a control unit, in order to dispense a predefined amount of bone cement from the container by means of the press-out unit.

Abstract: Neuromodulation of nasal nerves to treat diseases is described where one example of a method for treating dysfunctions or diseases in a patient may generally include introducing a treatment device into a nasal cavity of a patient. The distal end of the treatment device may be navigated into proximity of nerve fibers passing through at least one of lesser palatine foramen, a palatovaginal foramen, or a sphenopalatine foramen, or anterior ethmoid foramen. The distal end may then be actuated to ablate all or substantially all of the nerve fibers such that the dysfunction or disease is mitigated.

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

Abstract: An instrument according to the invention for plasma treatment of biological tissue comprises plasma exit windows in form of openings, which widen or taper in longitudinal direction. In doing so, inclined positions of webs result, which are present between the individual openings and which seamlessly monolithically connect a proximal section of the instrument head with a distal section. Due to the inclined position of the webs, the shading effect is minimized or eliminated.

Abstract: An instrument for plasma treatment of biological tissue comprises plasma exit windows in the form of openings having an edge extending obliquely relative to the longitudinal direction (L), which can be formed by flank of a web. The webs taper in radial direction (+R) and are preferably obliquely inclined relative to the longitudinal direction (L). The webs support a proximal section of the instrument head and connect the latter seamlessly monolithically with a proximal part of the head. Due to the outward tapering of the webs, their shading effect is minimized or eliminated.

Abstract: An electrosurgical system and a method for the operation thereof are disclosed. The electrosurgical system includes a supply apparatus and an electrosurgical instrument connected thereto having at least one instrument electrode. By means of the instrument electrode, biological tissue of a patient can be treated, for example by creation of a spark between the instrument electrode and tissue. The supply apparatus evaluates at least one operating parameter of the operating circuit, which includes the electrosurgical instrument and the treated tissue, and which is supplied with electrical power by the supply apparatus. A tissue type of the treated tissue is recognized by evaluation of at least one operating parameter. Thereupon at least one electrical parameter of the provided electrical power can be adapted or modified so that the electrical power provided to the electrosurgical instrument is optimized for the tissue type of the currently treated tissue.

Abstract: An electrosurgical instrument has a power supply operatively coupled to an end effector. The end effector has a pair of jaws for effectuating an action on tissue positioned therebetween. The power supply is configured to input a first signal and a second signal to a buck-boost converter. The buck-boost converter is configured to transmit an output to an H-bridge circuit. The H-bridge circuit is configured to pass a signal to a resonant LC transformer circuit. The power supply is configured to transmit a power signal. The pair of jaws are operatively coupled to the power supply to receive the power signal, the power having no more than 80 Volts RMS, and less than 2 Amps RMS. The power is configured to seal the tissue positioned between the pair of jaws in 3 seconds or less.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: A device is described for treating a nasal airway by modifying a property of a nasal tissue of or near a nasal valve of the airway, without using a surgical incision or an implant, to decrease airflow resistance or perceived airflow resistance in the nasal airway. Various embodiments include an elongate shaft, a bipolar radiofrequency delivery member extending from one end of the shaft, and a handle attached to the elongate shaft at an opposite end from the radiofrequency delivery member. The radiofrequency delivery member is sized to be inserted into a nose and configured to at least temporarily deform the nasal tissue and deliver radiofrequency energy. The radiofrequency delivery member includes two rows of protruding electrodes disposed on a tissue contact surface, and the device is configured to deliver radiofrequency energy from one row of electrodes to the other row of electrodes.

Abstract: A multifunctional laparoscopic suction and irrigation surgical grasping tool using a laparoscope, an endoscope, colonoscope, or gastroscope for the deployment of a grasper with diathermy, suction, and irrigation into a surgical field of view. Once optimally positioned, the grasper can remove tissue while providing a coagulating electric charge to the area from which the tissue is removed. Suction and irrigation can also be selectively deployed as needed during the tissue removal process.

Abstract: Devices, systems, and methods for removing or dividing valve leaflets, wherein the devices have an elongate shaft and a cutting tool disposed on or near a distal end of the shaft. Certain embodiments include a cutting tool comprising an expandable structure with a cutting element associated with the expandable structure. Other embodiments have a cutting tool that can extend out of an opening in the elongate shaft. Further implementations have a cutting tool that is a laser fiber, an ultrasound emitting tool, or a radiofrequency emitting tool. Some specific embodiments have a first expandable structure disposed at or near a distal end of the elongate shaft, and a second expandable structure disposed on the elongate shaft proximally of the first expandable structure, the second expandable structure comprising at least one distal projection, wherein the at least one distal projection comprises a cutting tool.

Abstract: A leakproof straw lid includes a lower lid and an upper lid. The lower lid is removably connected to a liquid containing vessel and includes a straw receiving hole for receiving a straw and a straw closing mechanism positioned adjacent the straw receiving hole. The upper lid is attachable to the lower lid and includes a straw receiving hole aligned with the straw receiving hole in the lower lid and at least one closing element configured to engage the straw closing mechanism in the lower lid. Rotation of the upper lid causes the at least one closing element to engage the straw closing mechanism which operates to compress or squeeze the straw and close the same.

Abstract: A system and method use impedance, optionally in combination with one or more imaging techniques (e.g., US, CT, MRI, PET scan, SPECT, fluoroscopy, endoscopy) to discern between diseased and healthy tissue, and/or to determine location, size, boundaries and/or multifocal foci of diseased tissue. Impedance is measured between groups of electrodes. The electrodes may be inserted with a plurality of interstitial probes positionable within tissue (e.g., prostate). One or more electrodes may be mounted on each probe. An algorithm (e.g., machine learning capable) may discern diseased tissue and/or compile a histological map of the tissue. The same system optionally delivers ablative energy, or electroporation and/or electrochemotherapy to identified diseased (or high risk) tissue as a treatment modality. Mapping, treatment on the mapping and/or post-treatment scanning may be performed via the same device. The multi-use system may reduce navigating of the tissue to deliver focal treatment to tumor foci.

Abstract: A method of performing a rhizotomy includes directing a surgical probe through an incision in the body of a patient, navigating a distal tip of the probe to a location adjacent a target nerve, energizing the probe to deliver energy to the target nerve, and wanding the distal tip of the probe in a plurality of directions to direct the energy at the target nerve to interrupt signal transmission by the target nerve.