Abstract: A deflection detector and a control method thereof, an electric stapler, and a medical device. The deflection detector is applied to a detection on a deflection action of an operating end of a medical device, including: a driving portion, used to perform a rotation action to provide a driving force for achieving the deflection action of the operating end; an interface portion, in transmission connection with the driving portion and used to convert the rotation action of the driving portion into a linear movement action along an axial direction; and a detecting portion, on the interface portion and used to detect a movement position of the linear movement action of the interface portion along the axial direction relative to a supporting portion, so as to complete the detection on the deflection action.

Abstract: A computer-assisted medical system includes a display unit configured to provide images to an operator of the display unit, a headrest configured to receive a mechanical input provided by a head of the operator in mechanical contact with the headrest, a headrest sensor interfacing with the headrest and configured to provide sensor signals based on the mechanical input, and a controller. The controller includes a computer processor, and is configured to process the sensor signals to obtain a driving input, drive, by the driving input, a virtual mass to obtain a simulated virtual mass movement, and cause movement of the headrest, the movement of the headrest tracking the virtual mass movement.

Abstract: A rack and “U-shaped” stringers for use in stringing of ring-handled medical instruments in preparation for at least one of an assembly operation, an assembly count operation, a storage procedure, a decontamination operation, a sterilization process, and/or a disinfection operation, involving such instruments.

Abstract: A sterile holder for sterile surgical implants. The implant holder is an ergonomically shaped body of deformable material having an implant-receiving cavity similar in size and shape to the implant. To remove the implant from the holder, the surgeon mates a sterile tool to the implant and gently pries the implant out of the holder by deforming the body. Preferably the tool used to pry the implant out of the body is an insertion tool mated to the implant which is also used to insert the implant in a patient. In this way the surgeon retrieves the implant from its container without touching the container and directly inserts the implant in the patient without risking contamination: sterility is maintained for both the surgeon and the implant. In a preferred embodiment, the implant holder is configured to hold two pedicle screws and their set-screws.

Abstract: Packaging systems are used for medical devices. For example, this document describes packaging systems for implantable medical devices such as, but not limited to, prosthetic heart valves that are deliverable in a minimally invasive manner using a system of catheters. Some embodiments of the packaging systems described herein are designed to facilitate preparation processes that clinicians perform to prepare the medical devices for implantation.

Abstract: Container (1) and kit for washing and/or disinfecting and/or sterilising medical instruments comprising a frame (10), made of a polymeric material and defining a containment volume (V) and a plurality of containment panels (20), made of a metal material, constrained or constrainable to the frame (10) and defining a bottom wall (21), an upper wall (22) and a plurality of side walls (23, 24, 25, 26) of the container (1) so as to delimit the containment volume (V). Furthermore, the containment panels (20) have a plurality of holes suitable for the passage of a washing fluid. Not least, the containment panels (20) have a planar shape.

Abstract: A box including: a receptacle; a plate fastened on the receptacle and including an aperture for the introduction of wastes; a cartridge containing a waste disinfection fluid, the cartridge being mounted in the receptacle and including a casing and an actuator movable relative to the casing between an inactive position and an active position in which fluid can be expelled through an expulsion hole; a cover which is mounted on the plate and which includes means for activating the actuator of the cartridge. When the cover is in an open position, the actuator is in an inactive position, and the switch of the cover into the closed position causes the switch of the actuator into the active position by the action of the activation means.

Abstract: Method and apparatus are disclosed for esophageal heat transfer devices and methods for cardiac tissue ablation procedures. An exemplary method includes collecting esophageal data via one or more sensing elements of an esophageal heat transfer device positioned within an esophagus of the patient. The exemplary method includes determining, based on the esophageal data and/or operator selected power setting, a temperature setting and/or a flow rate setting for fluid flowing through the esophageal heat transfer device to maintain a target temperature of esophageal tissue adjacent to the ablation site via a heat transfer region. The exemplary method includes adjusting, via the controller, a fluid source to provide the fluid to the esophageal heat transfer device at the temperature setting and/or a flow rate setting.

Abstract: Examples relate to a surgical microscope system, and to a corresponding system, method, and computer program for a surgical microscope system. The system comprises one or more processors and one or more storage devices. The system is configured to track a progress of a surgical procedure. The system is configured to select two or more of a plurality of functionalities of the surgical microscope system based on the progress of the surgical procedure. The system is configured to assign the two or more functionalities to two or more input modalities of the surgical microscope system. The system is configured to generate a visual overlay with a visual representation of the two or more functionalities. The two or more functionalities are shown in relation to a visual representation of the two or more input modalities. The system is configured to provide a display signal to a display device of the surgical microscope system, with the display signal comprising the visual overlay.

Abstract: A tissue removal system may include a tissue removal device including a handpiece and an upper housing, and configured with an outer cannula having an outer cannula opening for severing tissue, an inner cannula disposed in the outer cannula and reciprocal within the outer cannula, an illumination device having a sleeve arranged at least partially on the outer cannula, and a fiber optic channel defining an opening and arranged offset from the sleeve, and a light source arranged within the channel and configured to supply light from the opening to a surgical site.

Abstract: Systems for mounting medical equipment in a configurable manner are provided. In one example, a mounting system comprises a clamping portion configured to removably couple to a truss structure. The clamping portion has a first mounting support and a second mounting support. The first and second mounting supports are configured to couple to each other on opposite sides of a portion of the truss structure. The second mounting support has features complimentary to a shape of the truss structure to allow sliding engagement of the truss structure. The mounting system further comprises an engagement portion having at least one opening. The one opening is configured to receive one or more fasteners to couple to an equipment mount, and the engagement portion extends from the first mounting support of the clamping portion.

Abstract: The invention relates to a method for operating a visualization system in a surgical application, wherein at least one image representation of a region to be operated on and/or operated on is captured by means of a capturing device, wherein the at least one image representation is displayed on a main display device, wherein a pose of a visualization device that can be worn on the head relative to a display surface of the main display device is captured by means of a pose sensor system, and wherein at least one three-dimensional augmentation information item corresponding to the at least one image representation displayed is generated and/or provided and is displayed on a display device of the visualization device, wherein the augmentation information item is generated and/or provided in consideration of the captured pose in such a way that the at least one image representation displayed on the main display device is extended into a three-dimensional region by the at least one three-dimensional augmentation in

Abstract: Systems, methods, and non-transitory computer readable media for automated analysis of video data during surgical procedures using artificial intelligence are provided. Surgical footage of an ongoing surgical procedure may be received and analyzed. The analysis may detect prospective adverse actions in surgical procedures based on the presence of a surgical instrument in a surgical cavity and a phase of the ongoing surgical procedure. The analysis may trigger removal of tissue for biopsy in an ongoing surgical procedure based on a likelihood that a feasible biopsy will cause a diagnosis of a condition other than a known condition of the patient. The analysis may facilitate addressing time sensitive situations in surgical procedures, for example by providing notification when no action to address a time sensitive situation is initiated within the selected time period.

Abstract: An illustrative surgical system may access a plurality of images captured outside a structure within a patient; detect a difference between spectral reflectances of scenes captured in the plurality of images; and identify, based on the detected difference between the spectral reflectances of the scenes captured in the plurality of images, pixels in at least one of the plurality of images that correspond to structure tissue of the structure.

Abstract: An apparatus for aligning a medical object with respect to an examination object includes an alignment element that may be fastened on or integrated into the medical object, having a number of at least point-shaped markers. The apparatus includes a processing unit configured to receive medical image data and identify positioning information relating to a positioning of the medical object. The apparatus includes a representation unit configured to show a graphical representation of the medical image data and an item of alignment information. The alignment information relating to the markers has a corresponding virtual continuation of the medical object in each case, which corresponds to virtual arrangements of the medical object. The apparatus includes a light guiding facility configured to emit a predefined light distribution such that one of the markers is illuminated by the light distribution when the medical object is aligned according to the corresponding virtual continuation.

Abstract: A diagnostic marker tool is provided for use with x-ray imaging and/or magnetic resonance imaging diagnostic methods. The diagnostic marker tool comprises a marker body having first and second opposed major surfaces; a first suction element positioned at the first major surface and a second suction element positioned at the second major surface. A non-metallic and/or radio-opaque indicator element is then associated with the marker body.

Abstract: An apparatus for attaching a medical imaging device to a cannula for conjoined movement with the cannula to allow simultaneous manipulation of the imaging device and the cannula with one hand during an image-guided medical procedure. The image-guided medical procedure may be a liposuction procedure. The apparatus may have a cannula handle assembly, a rigid extension arm, and a probe holder assembly. The handle assembly is configured to removably receive and hold a cannula and the probe holder assembly is configured to removably receive and hold an imaging probe. The extension arm is connected at one end to the handle assembly and at its other end to the probe holder assembly to position an imaging probe with its imaging end approximate to and facing the cannula tip so that the cannula tip can be imaged by the probe during a procedure.

Abstract: A self-retaining surgical flap retractor and method of using the same for the surgical extraction of impacted third mandibular molars of a patient. Once optimally positioned, the self-retaining surgical retractor pushes against the mucoperiosteal flaps keeping them away from the surgical site. The system and method also provide integrated functionalities of suction and illumination within the self-retaining surgical retractor.

Abstract: A method for manufacturing a personalized corrective dental aligner for correcting a patient's oral system, the method being implemented by a computer system, characterized in that it comprises the following steps: (1) receiving an initial 3D model of the patient's oral system; (2) determining functional, orthopedic and orthodontic diagnostic factors; (3) determining corrective parameters based on these factors; (4) generating a corrective 3D model from the initial model, corrective parameters and diagnostic factors; (5) generating at least one 3D model of a customized corrective aligner to transform the initial model into a corrective model; (6) manufacturing a corrective aligner from a 3D model of a customized dental aligner.

Abstract: A system includes a memory and a processing device operatively coupled to the memory. The processing device receives an image of a smile of an individual comprising initial contours of teeth of the individual, receives or generates image data comprising target contours of the teeth of an individual, and generates a new image based on the received image data and one or more parametric functions associated with tooth color determined from the image of the smile, wherein a shape of the teeth in the new image is based on the received image data and a color of the teeth in the new image is based on applying the one or more parametric functions to at least a portion of the image data.

Abstract: Methods for designing and fabrication of a series of apparatuses for expanding a patient's palate (“palatal expanders”). In particular, described herein are methods and apparatuses for forming palatal expanders, including rapid palatal expanders, as well as series of palatal expanders formed as described herein and apparatuses for designing and fabricating them.

Abstract: A tool and method for seating an orthodontic aligner. In one aspect, the tool comprises a handle portion and a seating portion. The seating portion is connected to the handle portion. The seating portion comprises a first rippled structure and a second rippled structure. The first rippled structure and the second rippled structure each comprising one or more series of waves. The tool can further comprise a first material and a second material. The first material is more elastic than the second material, and the second material is more rigid than the first material. In another aspect, the method comprises holding a handle portion of the tool, positioning the seating portion of the tool between sets of teeth, and causing the seating portion of the tool to be pressed between the sets of teeth.

Abstract: A dental braces includes at least one fixing element attached to surfaces of multiple abnormal teeth and provided with a first connector, and an orthodontic element provided with a second connector adapted to the first connector, where the second connector is engaged with the first connector to form an interference fit, such that the orthodontic element is detachably connected to the fixing element; and an elastic force of the orthodontic element acts on the abnormal teeth to control movement of the abnormal teeth.

Abstract: An orthodontic device with adjustable tightness includes an orthodontic base and a buckling plate. The orthodontic base includes a fixing plate fixed on the tooth and a protrusion disposed on the fixing plate. The protrusion includes a groove provided for an archwire to pass through, and a side wall adjacent to the groove. The side wall includes a plurality of clamping grooves. The heights between each of the clamping grooves and a bottom wall of the grooves are different. The buckling plate includes a pressing section located above the archwire, and the pressing section is selectively inserted into one of the clamping grooves. A vertical distance between the pressing section and the bottom wall is between a first value and a second value, wherein the first value is smaller than a thickness of the archwire, and the second value is greater than a thickness of the archwire.

Abstract: An orthodontic bracket is disclosed. The orthodontic bracket according to the present invention includes: a bracket body having a slot formed through the bracket in a direction of right and left; and a bracket cover movably provided on the bracket body to open and close a top of the slot. The bracket cover includes: a cover body provided at a side of the slot for moving forward and backward across the slot; and crossing protrusions formed at a front end of the cover body which faces an opposite side of the slot. and protruding forward with gaps in the direction of right and left. According to the present invention, since when the bracket cover is closed for ligating a wire, the front end of the bracket cover can smoothly slide over the wire, so the bracket cover can be easily closed.

Abstract: An accurate and precise surgical guide for dental procedures, especially a procedure involving a subject with few or no teeth as well as methods for making and use of such guides.

Abstract: The present invention relates to a bridge style dental prosthetic for replacing multiple lost or damaged teeth. More specifically, the present invention relates to an appliance comprising a base made of a first non-compressive material that is indefinitely affixed to the patient's jaw and a dentition portion that is made of a second compressive material and is removably affixed to the base portion, thus allowing restoration and/or replacement of the dentition portion without the need to remove and/or replace the base portion. The invention may include a dentition channel adapted to receive and removably secure the dentition to the base. The invention may also include a post disposed in the lower surface of the dentition that is received by an opening in the distal surface of the base to removably secure the dentition to the base.

Abstract: A three-dimensional scanner includes imaging circuitry configured to take an image of an object located at a focal position of a lens, a lens driver configured to drive the lens to make reciprocating motion in a linear direction, an angle detector configured to detect variation in angle of inclination of the lens with respect to a prescribed direction, and processing circuitry configured to control an operation of the lens in accordance with the variation in angle of inclination detected by the angle detector.

Abstract: A three-dimensional scanner includes a lens, imaging circuitry that obtains an image of an object located at a focal position of the lens, a lens driver that drives the lens to make reciprocating motion in a linear direction, obtaining circuitry that obtains geometrical data representing a surface geometry based on an image taken by the imaging circuitry, and lens controller circuitry that controls the lens driver to change an amplitude of reciprocating motion of the lens based on the geometrical data obtained by the obtaining circuitry.

Abstract: A method and system are provided for manufacturing a physical dental model. A virtual model is provided representative of at least a portion of the intra-oral cavity including at least one dental implant implanted therein, and the virtual model includes a virtual portion representative of each dental implant. The virtual spatial disposition of each such virtual portion is determined with respect to the virtual model, corresponding to a real spatial disposition of the respective implant with respect to the intra oral cavity. A physical model is then manufactured based on the virtual model, the physical model including a physical analog corresponding to each implant at a respective physical spatial disposition with respect to the physical model corresponding to the respective virtual spatial disposition of the respective virtual portion with respect to the first virtual model as already determined.

Abstract: An oral irrigator tip (or broadly an accessory for an oral hygiene device) may include an outlet, and a filtering element configured to filter a fluid flow to the outlet (e.g., through a tip body). The filtering element may be positioned to be in fluid communication with a chamber configured to hold an oral agent to be delivered to a user's oral cavity. A releasable connection may secure the tip body in a use configuration. The filtering element (e.g., a filter or screen) may be associated with (e.g., secured to, held by, etc.) the body.

Abstract: A dental irrigator has a connection portion with a water inlet, a main body, a working tip and an intermediate connector. The main body has a first end with a first connection element to couple with the connection portion and a second end opposite to the first end and having a second connection element which extends from a main step of the main body. The second connection element has an inner connection surface and an outer connection surface. The working tip has a first portion to be connected to the inner connection surface and a second portion to project the water outside the dental irrigator. The intermediate connector manages the connection between the first portion of the working tip and the second connection element of the main body.

Abstract: In one embodiment, the present disclosure is directed to a method for providing a personal toothbrushing challenge via an application of an electronic device. A user interface displays to a user of an electronic device, via a user interface, challenge parameters for creating a personal toothbrushing challenge, the challenge parameters including a type of challenge and a challenge period. The user interface receives from the user a parameter selection for each of the challenge parameters, each combination of parameter selections having a corresponding brushing expectation and point value. The electronic device receives brushing data from a user toothbrush indicative of user brushing activity, and determines, based on the brushing data, whether the user satisfied the brushing expectation corresponding with the combination of parameter selections. Upon determining that the user satisfied the brushing expectation, the user interface displays that the corresponding point value has been awarded to the user.

Abstract: A disposable dental vacuum line cleaning device has a first section having a fluid input end that is adapted to be connected to a source of water, a tapered section, a straight section, and a first hemispherical section, and a second section having an output end that is adapted to mate with a valve, a straight section, an intermediate section, a second hemispherical section having a peripheral edge that is larger than the first hemispherical section so that the first hemispherical section is captured within the second hemispherical section, and a chemical positioned within the first section and the second section.

Abstract: A dry mouth hydrating device includes a generally U-shaped tray having a base and two parallel arms extending from the base; a cavity defined within the tray providing a reservoir for the placement of a liquid; a first aperture defined in the base of the tray, in communication with the cavity; and tubing provided between the first aperture and the cavity for allowing the liquid to flow out of the cavity at a desired rate. The tray is adapted to surround the upper teeth of the wearer and to be retained within the oral cavity along the dental arch between the lips and gums. Once positioned on the upper teeth of the wearer, liquid can drip from the cavity over the tongue of a user wearing the device for treating or preventing xerostomia. A second, resealable aperture may be defined in communication with the cavity to allow the cavity to be refilled.

Abstract: Oral appliance delivery trays for use in maintaining or improving oral health, particularly the sub-gingival region, are provided. Methods of manufacturing individualized oral appliance delivery trays are provided. Pre-fabricated oral appliance trays including a compound pre-disposed therein are provided. The compositions and methods may be used to maintain or improve oral, periodontal and systemic health or to prevent or slow, periodontal or systemic health issues related to the oral cavity.

Abstract: A kit for the application of hydrophobic compositions to hydrophilic surfaces with an applicator device and a container for the hydrophobic composition. An applicator device for the application of an emulsion composition to wetted teeth. An applicator tip with at least one external ridge, a plurality of internal ridges, and a plurality of internal channels between the plurality of internal ridges. A container with a ribbon orifice for the dispensing of the emulsion composition.

Abstract: The present disclosure in one aspect provides a sterile packaging container comprising a container body with a cross-sectional shape that is constant along the majority of the longitudinal axis, a cover and a closure assembly that inhibits the passage of microbial contaminants. The container is configured such that the interior of the container can be sterilized. The sterile packaging container described herein allows one to manufacture a sterile packaging tube exercising the smallest possible volume.

Abstract: An occlusive device includes a covering component configured to modulate passage of blood or thrombus therethrough, and an occlusion frame that includes a plurality of elongate occlusion frame members. The elongate occlusion frame members are arranged to form a generally disc-shaped member. The occlusion frame is at least partially covered by the covering component. The device further includes an anchor frame that includes a plurality of elongate anchor frame members. The device further includes a first hub component from which the elongate frame members extend, and a second hub component from which the elongate frame members extend.

Abstract: A vascular graft includes an implantable tubular body defining a lumen and at least one support frame engaged to the tubular body for modifying a shape of a cross-section of at least a portion of the lumen. The tubular body and at least one support frame are configured to receive pulsatile blood flow so that as pressure of blood flowing through the lumen increases, a cross-sectional area of the portion of the lumen increases while a perimeter of the portion of the lumen remains substantially unchanged in order to dampen the pulsatile blood flow. A method of forming a vascular graft including a step of attaching at least one support frame to a tubular body defining a lumen that modifies a shape of a cross-section of at least a portion of the lumen of the tubular body is also disclosed herein.

Abstract: The described invention provides an endovascular device comprising a tube comprising at least one side-hole, a first segment comprising a primary opening and a second segment. The side-hole and the first segment form a working lumen. The second segment forms a support lumen where the support lumen is effective: (i) to provide stability to the working lumen of the endovascular device; (ii) to anchor the endovascular device within a blood vessel; (iii) to prevent catheter coil prolapse due to a counterforce against the endovascular device by one or more additional endovascular devices being delivered through the endovascular device to a more distal location or by a prolapsed coil tail of the endovascular device; and (iv) to facilitate placement of the second endovascular device distally.

Abstract: The present disclosure describes treatment of the vasculature of a patient with an expandable implant. The implant is constrained to a reduced delivery diameter for delivery within the vasculature by at least one sleeve. The implant can be constrained to other diameters, such as an intermediate diameter. The sleeves can be expanded, allowing for expansion of the diameter of the expandable implant, by disengaging a coupling member from the sleeve or sleeves from outside of the body of the patient. The expandable implant can comprise a steering line or lines which facilitate bending and steering of the expandable implant through the vasculature of a patient.

Abstract: An electrospun onlay for rotator cuff repairs and related procedures. The onlay includes an aperture and a conduit extending towards the aperture, wherein a longitudinal axis of the conduit is aligned with the aperture. The aperture and the conduit are configured to receive one or more surgical sutures therethrough. The scaffold is electrospun from one or more biocompatible polymers. In use, the onlay serves as a tissue growth scaffold to facilitate tendon-bone reattachment.

Abstract: An implantable prosthesis including a tissue infiltratable body of biocompatible material, the prosthesis having a body with a three-dimensional configuration to augment and/or reconstruct an anatomical shape of a human breast. The body includes a plurality of body segments stacked on top of one another about a longitudinal axis extending in a direction from a proximal end to a distal end of the prosthesis. The proximal end is configured to be positioned against facia in an anatomical space.

Abstract: According to one aspect of the disclosure, a prosthetic atrioventricular valve system includes a prosthetic atrioventricular valve having a self-expandable frame with a collapsed and expanded condition. In the expanded condition, the frame includes (i) a body portion sized to be positioned within, and in contact with, a native atrioventricular valve annulus, (ii) an atrial flare portion positioned in an inflow direction relative to the body portion, the atrial flare portion having an outer diameter that is greater than an outer diameter for the body portion, (iii) a plurality of commissure attachment features (“CAFs”) extending in an outflow direction from the body portion, and (iv) a commissure support ring coupled to and circumferentially supporting the plurality of CAFs. A plurality of prosthetic leaflets may be mounted to the CAFs. The body portion, the atrial flare portion, and the plurality of CAFs may be formed integrally.

Abstract: Disclosed are Valve Replacement devices, systems, and methods. Valve replacement devices may comprise One- or Two-Piece systems comprising an Adapter body and a Valve Assembly with leaflets positioned within the Adapter body. In Two-Piece systems, the Valve Assembly may be removable from the Adapter body such that both can be delivered together or separately, and the Adapter body may remain implanted while the Valve Assembly may be removed and replaced (i.e., “ReValved”). Also described are devices (such as a delivery catheter device), systems, and methods related to such delivering and Re Valving the Valve Replacement. Such delivery methods may include transseptal insertion of a new minimum leaflet structure, and securement of the Valve Replacement using several securement type (e.g., supra-annular, sub-annular, radial, leaflet securement, etc.). Also described is a braided helical design that mimics the heart's natural movement, and a flange structure for assisting the functioning of the Valve Replacement.

Abstract: A color-coded bioprosthetic valve system having a valve with an annular sewing ring, and a valve holder system with a holder sutured to the ring of the valve, a post operatively connected to the holder, and an adapter sutured to the post and having a color associated with the valve model and/or size. For example, the adapter may be blue to indicate that the valve of the system is a mitral valve of a particular type and/or size. The system may also include a flex handle that is configured to engage with the adapter. The handle has a color associated with the adapter such that a user is able to visually determine that the handle color matches the valve model. For example, the handle may have a grip that is colored blue to match the blue color of the adapter. Accordingly, the color-coded system enables users to confirm easily that the correct accessories such as the sizer or flex handle are being used with the correct valve.

Abstract: Delivery systems are used for medical devices. For example, this document describes delivery systems for implantable medical devices such as, but not limited to, prosthetic heart valves that are deliverable in a minimally invasive manner using a system of catheters.

Abstract: A balloon catheter system for delivering a prosthetic heart valve to a targeted site at a native valve of a patient includes a delivery shaft and a balloon fixedly attached to the delivery shaft. When the balloon is in a deflated state, a membrane material of the balloon defines a plurality of folded portions extending along a longitudinal axis of the delivery shaft. The balloon catheter system also includes a prosthetic heart valve disposed over the balloon when the balloon is in the deflated state and the prosthetic heart valve is in a collapsed state, a first set of folded portions of the plurality of folded portions extend clockwise about the longitudinal axis of the delivery shaft and a second set of folded portions of the plurality of folded portions extend counterclockwise about the longitudinal axis of the delivery shaft.

Abstract: Devices and methods for providing fluid to a lumen of a guide catheter with a fluid reservoir fluidly coupled to the lumen, such that pressure within the lumen is maintained at a desired level, are disclosed. As one example, a delivery apparatus can include a handle, a shaft extending within and distally from the handle and having a main lumen, and a reservoir fluidly coupled to the main lumen. The reservoir is filled with fluid and has an adjustable fluid volume, and the reservoir is configured to passively supply fluid to the main lumen based on a fluid pressure in the main lumen.