Abstract: Ultrasound image devices, systems, and methods are provided. In one embodiment, an intraluminal ultrasound imaging system includes a patient interface module (PIM) in communication with an intraluminal imaging device comprising an ultrasound imaging component, the PIM comprising a processing component configured to detect information associated with the intraluminal imaging device; and determine a waveform characteristic for ultrasound wave emissions at the ultrasound imaging component based on the detected information; and a trigger signal generation component in communication with the processing component and configured to generate a trigger signal based on the determined waveform characteristic to control the ultrasound wave emissions at the ultrasound imaging component.

Abstract: A system, apparatus and method for diagnosis of vaginal disorders, comprising a collection apparatus for collecting and sampling vaginal discharge or fluid and a sensing device for processing the sampling vaginal discharge or fluid, said sensing device comprising at least two lateral flow assays (LFAs).

Abstract: Provided in the present utility model is an inner container opening structure of a sperm extractor, including: a soft rubber inner container configured to massage a male genital organ; and a power mechanism mounted on the soft rubber inner container and configured to generate a vibration, where the soft rubber inner container includes an opening portion and a main body portion; the main body portion is mounted at the opening portion, and a channel is formed inside the opening portion and the main body portion; the power mechanism is disposed at the opening portion; a contact plate is disposed at a lower end of the opening portion; the power mechanism is mounted on the contact plate; and two arc-shaped grooves are further formed in the contact plate.

Abstract: A surgical instrument comprises a motor, a regulator, a converter circuit, and a control circuit coupled to the regulator and the converter circuit. The control circuit is to couple either the regulator, or the converter circuit based on a pre-determined load voltage or current applied to the motor.

Abstract: Modular surgical instruments or components that utilize a magnetic coupling to more securely attach to other surgical instruments and components are disclosed. The devices can be modular drivers for use with surgical instruments that utilize an actuation force, such as a spinal rod reducer. In one example, a surgical instrument driver can include a non-magnetic body having a proximal end and a distal end with a distal-facing recess configured to receive a portion of a surgical instrument. The recess can include a surface configured to contact the portion of the surgical instrument disposed in the recess to impart torque thereto. The driver can further include a magnet disposed within the body such that the magnet is configured to extend proximal to a proximal end of a surgical instrument disposed within the recess and radially outward beyond the proximal end of the surgical instrument disposed within the recess.

Abstract: An apparatus for sealing a puncture through a vessel wall including a positioning assembly, a sheath releasably engaged with the positioning assembly, and a support member axially advanceable through the sheath. The positioning assembly includes a positioning element positioned at a distal portion of the positioning assembly and a sealant disposed at a distal portion of the positioning assembly. The sheath guides the sealant and positioning assembly to the puncture in the vessel wall.

Abstract: A holding device for holding a patella in a holding plane includes two gripping elements that are connected to each other with a chain. The chain includes chain links. Adjacent chain links are movable relative to each other about a rotation axis that is perpendicular to the holding plane.

Abstract: A tubular retractor securement frame is disclosed including a mounting bracket, two flexor arms, and a device emplacement oriented to receive and hold in-place a surgical tool. The mounting bracket includes an elastically deformable plate, rails extending about orthogonal from the elastically deformable plate and about parallel to one another, and receptacles facing one another in the rails which are arranged to receive a retractor arm extending from a tubular retractor at a fixed angle. The flexor arms extend from the mounting bracket adjacent to the rails. The flexor arms are positioned so as not to occlude visualization through the tubular retractor and such that applying pressure to flex the flexor arms toward one another shifts the rails to accept or remove the retractor arm into or from the receptacles, and releasing the pressure reverts the rails so as to inhibit the retractor arm from being inserted or removed.

Abstract: Systems and methods to compress or anchor soft tissue are disclosed using one or more anchoring assemblies.

Abstract: A method and apparatus are provided for transtendinous implantation of a toggle-type bone anchor. Measured from the top surface of the tendon, the entire bone anchor is inserted to a depth of greater than or equal to 20 mm. during a rotator cuff repair on the humeral head. The anchor is pushed by the same bone punch that formed the initial hole to assure proper depth of placement. Further, the apparatus includes a nub portion that, in use, protrudes into the bone hole formed by the bone punch and maintains registration with the bone hole when the bone punch is retracted. An angled distal end on the anchor initiates toggling during insertion into the bone and at least one proximal projecting fin prevents the anchor from backing out of the bone hole while facilitating further rotation of the anchor when a suture is pulled to complete toggling.

Abstract: The present disclosure relates to a lifting thread having a flexible variable part in which a lifted portion is firmly fixed without drooping using a normal medical thread which is relatively inflexible, a structurally stretchable variable part is formed on one part of the medical thread, and pain is not caused at a surgical site and the medical thread is prevented from breaking even if muscles undergo large movements such as those at the time of laughing or yawning, which includes catching parts, each having a first fixing protrusion and a second fixing protrusion which face each other on both sides of a fixing groove formed in an outer peripheral surface of the medical thread and a length-variable part formed in a spring shape to be capable of generating elasticity between the catching parts, thereby having structural elasticity, and in which elasticity is provided to the medical thread as the spring shape of the length-variable part increases when an external force is applied thereto.

Abstract: A combined magnetic and bioabsorbable device for ventral hernia closure and/or tension distribution for maintenance of tissue apposition for healing, while avoiding a long-term footprint of foreign material and precluding materials spanning the interior layer of the abdominal closure where risk to visceral structures exists.

Abstract: A surgical system is disclosed that includes a motor, a power source, a voltage sensor, and a control circuit. The motor is operable between an on state in which the motor drives a motion at the end effector and an off state in which the motor ceases to drive the motion at the end effector. The power source is electrically coupled to the motor. The control circuit is configured to transition the motor to the on state for a first period, detect a dropped voltage potential of the power source at the end of the first period, conduct a comparison between the dropped voltage potential and the power source lower threshold, and transition the motor to the off state for a second period based on the comparison.

Abstract: A surgical instrument is provided. The surgical instrument comprises a shaft, a multi-axis articulation joint assembly defining a cavity therein, and a wiring assembly disposed within the shaft and the multi-axis articulation joint assembly. The multi-axis articulation joint assembly comprises a first articulation joint and a second articulation joint. The wiring assembly comprises a wiring harness having a thickness and a width greater than the thickness, and a preset twist. An articulation joint assembly is also provided.

Abstract: An adjunct for use with a surgical stapler is disclosed. The adjunct comprises a first layer comprising a first material. The adjunct comprises a second film layer (70070?) attached to the first layer. The second film layer defines a continuous textured device-contacting surface configured to establish a frictional interface with a corresponding portion of the surgical stapler. The second film layer comprises a second material that differs from the first material, the adjunct comprises a third film layer attached to the first layer. The third film layer comprises a tissue-contacting surface.

Abstract: A method for sequential firings of staple cartridges is disclosed. The sequential firings including a first firing that deploys first staples into a first tissue portion from a first staple cartridge and a second firing that deploys second staples into a second tissue portion from a second staple cartridge. The method comprises monitoring a parameter indicative of a tissue response associated with the first firing, assessing the tissue response based on the parameter, and adjusting an operational parameter associated with the second firing based on the tissue response during the first firing.

Abstract: A surgical system is configured to deploy staples from a staple cartridge reload into tissue. The surgical system includes a first sensor configured to measure a first parameter indicative of a force to form the staples, and a second sensor configured to measure a second parameter indicative of a position of a sled along a staple-forming distance. The system further includes a control circuit communicatively connected to a motor, the first sensor, and the second sensor, wherein the control circuit is configured to: receive a first signal from the first sensor indicative of the first parameter; receive a second signal from the second sensor indicative of the second parameter; and detect staple malformation of the staples based on the first signal and the second signals.

Abstract: A surgical stapling system is disclosed. The stapling system comprises a motor, a drive assembly comprising a drive train coupled to the motor to actuate a function of a surgical end effector, wherein the drive train is actuatable by the motor through a drive stroke, and a control circuit coupled to the drive assembly. The control circuit is configured to monitor a first parameter of the drive assembly during the drive stroke, determine a stored kinetic energy of the drive assembly based on the first parameter, monitor a second parameter of the drive assembly during the drive stroke, wherein the first parameter and the second parameter are different, compare the monitored second parameter to a parameter threshold indicative of a motor stall condition, and determine a motor setting of the motor based on the determined stored kinetic energy and the comparison of the monitored second parameter to the parameter threshold.

Abstract: A powered surgical instrument disclosed. The instrument includes a first circuit portion operable at a first voltage level, a second circuit portion operable at a second voltage level, a voltage source to supply the first voltage level to supply power to electrical components in the first circuit portion; a transistor comprising a control terminal, a first conduction terminal, and a second conduction terminal, and a control circuit coupled to the control terminal of the transistor. The second voltage level is different from the first voltage level. The first conduction terminal is coupled to the voltage source. The control circuit is to set the transistor in a linear mode and control the transistor to set a current for operating the motor.

Abstract: A surgical instrument comprises a shaft and an end effector extending from the shaft, the end effector comprising a staple cartridge comprising: a cartridge deck, a cartridge body, and a cartridge antenna supported by the cartridge body; a longitudinal channel, comprising: a base, a first wall extending from the base, a second wall extending from the base, wherein the second wall is spaced apart from the first wall to accommodate the staple cartridge therebetween in an assembled configuration, and a channel antenna supported by the first wall, wherein the cartridge antenna and the channel antenna are to cooperatively define a wireless signal-transfer circuit in the assembled configuration; and an aligner to interlock the staple cartridge and the longitudinal channel in the assembled configuration, wherein the aligner is adjacent the channel antenna and the staple cartridge antenna to maintain a predefined spatial relation between the channel antenna and the cartridge antenna in the assembled configuration.

Abstract: A method of assembling a staple cartridge is disclosed. In various embodiments, the method comprises attaching a pan to a cartridge body, the cartridge body comprising a proximal end, a distal end, a deck, longitudinal rows of staple cavities extending between the proximal end and the distal end, and a longitudinal slot extending from the proximal end toward the distal end. The method further comprises positioning staples in the staple cavities, positioning a support in the longitudinal slot such that an end of the support extends above the deck, and positioning a sled in the cartridge body proximal to the support such that the sled is longitudinally aligned with the support.

Abstract: A surgical stapling assembly comprising a first jaw, a second jaw, and a staple cartridge assembly positioned in the first jaw is disclosed. The staple cartridge assembly comprises a plurality of staples, a plurality of staple drivers, and a cartridge body. The cartridge body comprises a deck surface configured to support patient tissue, a longitudinal slot defined in the cartridge body, a plurality of staple cavities, and a longitudinal wall extending vertically below the deck surface. The longitudinal wall comprises a first zone comprising a first wall height and a second zone comprising a second wall height. The staple cartridge assembly further comprises a sled movable longitudinally through the cartridge body, wherein the sled is sized and configured resist deflection of the cartridge body during the firing stroke within the second zone.

Abstract: A surgical stapling assembly comprising a cartridge body, a plurality of staples, a plurality of staple drivers, a sled, and a support plane is disclosed. The cartridge body comprises a deck, a plurality of staple cavities defined in the deck, a longitudinal slot defined in the deck, and an outer cartridge wall. The support plane extends perpendicular to a longitudinal axis, wherein the sled is positioned under an inner cartridge wall in the support plane, wherein the inner cartridge wall comprises a first lateral pillar width and a first pillar height in the support plane, wherein the outer cartridge wall comprises a second lateral pillar width and a second pillar height in the support plane, and wherein the first lateral pillar width is wider than the second lateral pillar width.

Abstract: A staple cartridge for use with a surgical instrument, the staple cartridge comprising a cartridge body, a staple, a staple driver, and a sled is disclosed. The sled is movable from a proximal position to a distal position during a firing stroke and is movable from the distal position toward the proximal position during a retraction stroke. The sled comprises a first rail comprising a first distal-facing ramp, a second rail comprising a second distal-facing ramp, and a driver lift cam positioned intermediate the first rail and the second rail. The first distal-facing ramp and the second distal-facing ramp are configured to engage and move the staple driver from an unfired position to a fired position during the firing stroke. The driver lift cam is configured to engage the staple driver and move the staple driver toward the fired position during the retraction stroke.

Abstract: Surgical staple cartridges with sled configurations configured to be coupled to a firing driver of a compatible surgical stapling instrument such that the sled is retractable from a fired position within the staple cartridge to a released position wherein the firing driver decouples from the sled at a location that is distal to an unfired position of the sled.

Abstract: A stapling assembly comprising a cartridge body, staple drivers, staples, and a sled assembly is disclosed. The cartridge body comprises a deck, a longitudinal slot, and staple cavities defined in the deck. The sled assembly is configurable in a first configuration and a second configuration. The sled assembly is movable distally in the first configuration during a staple firing stroke. The sled assembly is movable proximally in the second configuration during a retraction stroke. The sled assembly comprises a first component and a second component. The first component comprises a base and at least one rail extending from the base. The rail comprises a distal-facing ramp configured to engage the staple drivers to eject the staples from the staple cavities during the staple firing stroke. The rail is comprised of metal. The second component is movable within the longitudinal slot. The first component is movable relative to the second component.

Abstract: A surgical stapling system is disclosed comprising an end effector, a closure actuator, and a closure lockout. The end effector comprises an elongate channel, an anvil, and a pivot pivotably coupling the anvil to the elongate channel. The anvil is pivotable relative to the elongate channel between an open position and a closed position. The closure actuator is movable from a first position toward a second position during a closure stroke. The closure actuator is configured to move the anvil toward the closed position. The closure lockout is configurable between a locked state in which the closure lockout engages the closure actuator at a location proximal with respect to the pivot to prevent the closure actuator from moving the anvil toward the closed position and an unlocked state in which the closure actuator is permitted to move the anvil toward the closed position.

Abstract: A surgical stapler is disclosed comprising a firing beam, a firing bar movable to transition the firing beam from a proximal position toward a distal position, and a firing lockout comprising a first lockout arm extending on a first lateral side of the firing bar. The firing bar comprises a plurality of laminated strips. The plurality of laminated strips comprises a central laminated strip and a first subset of laminated strips. A first notch is defined in the first subset of laminated strips. The first lockout arm comprises a first projection. The firing lockout is configurable between a locked state in which the first projection is received in the first notch to prevent the firing beam from moving toward the distal position and an unlocked state in which the first projection is displaced from the first notch to permit the firing beam to move toward the distal position.

Abstract: A staple cartridge comprising a cartridge body including a deck and projections extending from the deck is disclosed. When used with a surgical stapling instrument, the deck of the staple cartridge can be compressed against patient tissue before the staples contained in the staple cartridge are ejected. The projections are engaged with the patient tissue and hold the patient tissue in place. The staple cartridge further comprises an electrical trace defined on the deck that extends between at least two of the projections. The electrical trace is part of a sensor system that detects properties of the patient tissue positioned against the projections.

Abstract: The present disclosure relates to adapter assemblies for use with and to electrically and mechanically interconnect electromechanical surgical devices and surgical loading units, and to surgical systems including hand held electromechanical surgical devices and adapter assemblies for connecting surgical loading units to the hand held electromechanical surgical devices.

Abstract: A surgical instrument includes a body having a firing actuator, a shaft, a motor, an end effector, and a control circuit. The motor is configured to activate in response to a firing actuation of the firing actuator. The end effector is operable to staple and sever tissue and includes a cutting edge configured to selectively translate longitudinally between a proximal position and a distal position in response to an activation of the motor. The control circuit is configured to generate a forward motor control signal to pulsate the cutting edge. The forward motor control signal includes a first time duration including movement of the cutting edge distally from the proximal position to a second longitudinal position, a second time duration including ceased movement of the cutting edge, and a third time duration including movement of the cutting edge distally from the second longitudinal position toward the distal position.

Abstract: A surgical system for use in a surgical procedure to perform sequential firings of staple cartridges is disclosed. A control circuit is to monitor a parameter indicative of a tissue response associated with a first firing, assess the tissue response based on the parameter, and adjust an operational parameter associated with a second firing based on the tissue response during the first firing.

Abstract: A surgical instrument comprising a staple cartridge including a cartridge body, staples removably stored in the cartridge body, and staple drivers movable within the cartridge body to eject, or deploy, the staples from the cartridge body is disclosed herein. The staple drivers and the cartridge body comprise control surfaces that promote the efficient deployment of the staples from the cartridge body.

Abstract: A staple cartridge assembly for use with a surgical stapling instrument is disclosed. The staple cartridge assembly comprises a plurality of staples, a plurality of staple drivers, and a cartridge body comprising a retention feature. The staple cartridge assembly further comprises a sled movable longitudinally through the cartridge body from a proximal unfired position to a distal fired position during a firing stroke, wherein the sled comprises a ramp configured to lift the staple drivers toward a deck to eject the staples from staple cavities during the firing stroke, wherein the sled comprises a longitudinally-extending slot, wherein the retention feature supports at least one of the staple drivers in an unlifted position, and wherein the longitudinally-extending slot of the sled is configured to receive the retention feature during the firing stroke.

Abstract: A surgical stapling system is disclosed that includes a firing drive, a first lockout, and a second lockout. The firing drive comprises a first edge and a second edge. The first lockout is configurable between a first locked state in which the first lockout engages the first edge during the firing stroke and a first unlocked state in which the first edge bypasses the first lockout during the firing stroke. The second lockout is configurable between a second locked state in which the second lockout engages the second edge during the firing stroke and a second unlocked state in which the second edge bypasses the second lockout during the firing stroke. A staple cartridge is seatable in the stapling system that comprises a first key that unlocks the first lockout and a second key that unlocks the second lockout.

Abstract: A surgical stapling system is disclosed that comprises a closure driver, a firing driver, and a control circuit. The control circuit is to set a firing force threshold, advance the closure driver, advance the firing driver, monitor a firing force as the firing driver is advanced, compare the firing force to the firing force threshold, and control movement of at least one of the closure driver or the firing driver based on results of the compare and a zone in which the firing driver is positioned.

Abstract: A staple cartridge for use with a surgical stapling instrument is disclosed. The staple cartridge comprises a deck comprising a first staple cavity adjacent a longitudinal slot, a second staple cavity laterally and longitudinally offset relative to the first cavity, and a third staple cavity laterally and longitudinally offset relative to the second cavity. A first projection surrounds the first staple cavity, a second projection surrounds the second staple cavity, and a pair of third projections surrounds first and second portions of the third staple cavity, respectively. The first projection and the second projection are coupled together, and the second projection and one third projection are coupled together. The projections define a localized tissue-facing surface area. A localized valley is defined on the deck between the projections. The area of the localized valley area is greater than the localized tissue-facing area.

Abstract: A powered or robotic surgical stapler includes a loading unit having an end effector with an anvil and staple cartridge. A drive shaft disposed in the loading unit is actuated by one or more motors. The drive shaft approximates the anvil and advances a knife and a sled to eject a plurality of staples from the cartridge. A position sensor and a torque or current draw sensor measure operation of the motor and a processor determines an initial peak in the torque or current. The processor then calculates a stop position from the drive shaft based on a motor position corresponding to the initial peak and actuates the drive shaft until it reaches the stop position, which occurs prior to the drive shaft reaching a mechanical limit of the drive shaft.

Abstract: Surgical instruments and/or fastener apparatuses comprising an end effector with a pair of jaws pivoted at a proximal end thereof and movable between an open and closed position. At least one of the jaws may comprise a channel for receiving a cartridge containing a plurality of surgical fasteners. Also, an electrically powered actuator may be for deploying the surgical fasteners and may comprise a power source and a motor. An activation mechanism may be attached to the handle to move the pair of jaws from the open to the closed position and to activate the actuator. A lockout mechanism may be configured to permit current to flow from the power source to the motor when the pair of jaws is in the closed position and to prevent current from flowing to the power source to the motor when the pair of jaws is in the open position.

Abstract: An adjunct for use with a surgical stapling system is disclosed. The adjunct comprises a first region. The first region comprises a first composition. The adjunct comprises a second region. The second region is distal to the first region and comprises a second composition. The adjunct comprises a third region. The third region is distal to the second region. The third region comprises a third composition. The second composition differs from the first composition and the third composition.

Abstract: An implantable shunting device configured to shunt blood from the left atrium of the heart to the azygous vein through an aperture in the atrial septal wall is provided. The device comprises a flexible tube configured for radial adjustment between a contracted delivery configuration suitable for delivery in a delivery catheter and a deployed radially expanded configuration, the tube having a through lumen, a distal end configured to anchor within the azygous vein, and a proximal end configured to span an aperture in an atrial septal wall and anchor to the wall to provide fluid communication between the left atrium and the azygous vein. Methods of treating heart disease by implanting a shunting device of the invention are also disclosed.

Abstract: A vaso-occlusive device comprises an elongate vaso-occlusive structure configured for implantation in an aneurysm sac. The vaso-occlusive structure has a delivery configuration when restrained within a delivery catheter and has a deployed configuration when released from the delivery catheter into the aneurysmal sac. At least a portion of the vaso-occlusive device is composed of a gold-platinum (AuPt) alloy.

Abstract: A medical clip has two cooperating clamping arms and a biasing element. Each clamping arm is connected to an end of the biasing element by a connecting portion. The clamping arms are maximally proximate to one another, and may abut against one another, in a basic position of the clip, and are movable away from one another against the action of the biasing element from a basic position into an open position. The two connecting portions define a first circular cross section having a first diameter. The biasing element defines a second circular cross section having a second diameter smaller than the first diameter. The connecting portions taper toward the biasing element, such that conical transition regions are formed that define a cone angle. The cone angle can be at least 10°. A reshaping tool, a reshaping machine and a method can be used for producing a medical clip.

Abstract: A tissue clamping system (1) includes a tissue clamping device (100) and a driving component (200). The tissue clamping device (100) includes a clamping part (10), a first supporting part (20), a second supporting part (30), and a restricting part (40). The clamping part (10) includes at least two supporting arms (110) and at least two clamping arms (120) in one-to-one correspondence with the at least two supporting arms (110). The at least two supporting arms (110) are provided on the first supporting part (20), and the at least two clamping arms (120) are provided on the second supporting part (30). The second supporting part (30) includes a guiding element (320). The restricting part (40) passes through the first supporting part (20) and is fixedly connected to the first supporting part (20).

Abstract: A clipping system includes an adapter configured to be mounted over an insertion device and a clip including first and second jaws movable between an insertion configuration and an initial deployed configuration. A first extending member is releasably coupled to the clip and movably connected to the adapter to permit a movement of the clip relative to the adapter from the insertion configuration to the initial deployed configuration. The first extending member is configured to permit withdrawal of the adapter away from the clip to place the system in a review configuration to enhance a visual observation of the clip. The first extending member is operable to retract the clip over the adapter so that the clip is forced open, freeing the clip from tissue on which it has been clipped. The first extending member is configured to release the clip therefrom in a final deployed configuration.

Abstract: A cartridge system includes a main body portion having a plurality of clip storage areas. Each of the clip storage areas stores a clip, and each of the clip storage areas is provided with an opening through which an applicator can be inserted and a lid for independently opening and closing the opening.

Abstract: A pneumatic tourniquet has a constricting device that comprises a rocker, such that when the rocker is angularly displaced by contact with a wounded limb, a clamping force is applied by a rocker surface and a clamping edge onto a sealing element to prevent flow of the pressurized gas from an interposed inflated strap to a free end, causing the strap free end to be considerably thinner than the main strap section. In one embodiment, a gas flow control assembly comprises a casing containing a force transmitting element and a gas cartridge; and a pivotable activation handle, wherein, upon pivoted displacement of the activation handle, pressurized gas is caused to be discharged from the gas cartridge and flow to an interior of the strap. In other embodiments, the pneumatic tourniquet comprises one or more of a flow control unit, a manual pressure release initiator, and a puncture mitigating connection section.

Abstract: A system for making a resection of a bone having localized anatomical surface features prior to resection, comprising: a resection guide locator including a body, the body including opposing medial and lateral wings extending outwardly from the body, the body defining a recess being a socket defined by an annular wall, the annular wall including an upper wall, a lower wall, a resection guide having a body defining a resection slot, at least a portion of the resection guide body sized and configured to be received within the recess defined by the resection guide locator.

Abstract: A surgical instrument includes an outer tubular sleeve configured to receive a middle tubular member coaxially therethrough to define an irrigation pathway therebetween and therealong. An inner tubular shaft is rotatably received within the middle tubular member, a distal end of the inner tubular shaft forming a surgical bur configured to cut tissue or bone upon rotation thereof. One or more fluid exit ports is defined at the end of the irrigation passageway between the distal end of the outer tubular sleeve and the distal end of the middle tubular member. The fluid port(s) is configured to direct irrigation fluid in a narrow stream toward the surgical bur. The annular space between each respective fluid exit port at the end of the irrigation passageway is sealed to prevent irrigation fluid from leaking and obscuring the surgeon's view of the surgical bur.

Abstract: A tool for removing a stem implant that has been implanted within a bone can include a cutting section and a clearance section. The cutting section can extend from a proximal portion to a distal portion. The cutting section can include a blade configured to generally conform to an exterior geometry of the stem implant. The clearance section can be disposed adjacent to the cutting section such that a distal portion of the clearance section can be joined to the proximal portion of the cutting section. A proximal portion of the clearance section can be configured to receive and transmit forces to drive the cutting section along a desired trajectory for removal of the stem implant. The clearance section can be shaped to provide an offset that prevents interference with a neck of the stem implant while the cutting section is being driven along a desired trajectory.