Abstract: A tool for removing non-visually, urinary tract stents placed within the urinary tract of a patient, comprising a distal end, a longitudinally-extending stem, and a handle. The distal end has a conical head with a groove for hooking a stent, stent string or similar stent configuration. The snare head may have a channel for advancing the tool through a urethra over a guide wire. The snare head has a narrow conical front end for dilating urethral strictures. The stem connects the snare head to the snare handle and is made to be flexible or bend on encountering resistance.

Abstract: A tissue-removing catheter includes a cutter having an axial cavity and an opening extending from the axial cavity through the cutter to allow tissue removed from the body lumen by the annular cutting edge to pass proximally through the opening. A cutter driveshaft defines a tissue-transport passage extending longitudinally therein and in communication with the axial cavity of the cutter. A screw blade extends longitudinally within the tissue-transport passage and includes an external helical thread for transporting removed tissue proximally within the tissue-transport passage as the screw blade rotates about its axis. The cutter driveshaft having a distal end portion operatively coupled to the cutter for driving rotation of the cutter.

Abstract: An endoscopic surgical instrument with an elongate shaft, a surgical tool arranged at a distal end of the shaft for conducting surgical manipulations and a handle arranged at a proximal end of the shaft for actuating the surgical tool. The shaft has an elongate shaft tube and an elongate actuation rod arranged movably within the shaft tube, the tool and the handle both being connected to the shaft tube and the actuating rod such that the tool can be actuated by the handle through a motion of the actuating rod relative to the shaft tube.

Abstract: The present invention provides an irrigated ablation electrode that includes a plurality of high L/d interior fluid passageways and/or slit-shaped apertures to provide for a lower rate of fluid flow and a more uniform distribution of fluid over an exterior surface of the electrode and reduce propensity for aperture blockage. In some embodiments, the slit-shaped apertures have an aspect ratio of at least three, at least five, at least ten, or at least fifteen. Some embodiments include maintaining a pressure drop of at least 345 pascals between irrigation fluid inside the irrigated ablation electrode and fluid immediately outside the electrode when the irrigation fluid has a flow rate of no more than five milliliters per minute (5 ml/min). Some embodiments include a low-density insert with a plurality of fluid channels on its exterior surface to more efficiently cool the electrode and provide a faster thermal response.

Abstract: A single instrument head loading device for use in needlescopic surgery comprises a shaft having maneuverable structure on a proximal end for use in correctly positioning an instrument head at a distal end thereof through manipulation of at least one wire engaged to a distal end loader within which the instrument head is held by maneuvering the maneuverable structure at the proximal end, to which a proximal end of the at least one wire is attached, the at least one wire traversing the length of the shaft and the distal end loader being positioned in a suitable position allowing engagement of the instrument head under continuous direct visualization to a distal end of a cooperating shaft of a surgical instrument as well as allowing for disengagement of the instrument head back into the distal end loader under continuous direct visualization, the engagement and disengagement taking place within a body cavity.

Abstract: Embodiments of an actuated cannula seal are disclosed. In some embodiments, a cannula seal includes a base portion that engages with a cannula; and a seal portion integrally formed with the base portion, the sealing portion capable of engaging with an instrument shaft, the sealing portion capable of being actuated by an actuator so that the sealing portion is continually in motion relative to the instrument shaft. The actuation of the sealing portion can be accomplished by rotation or vibration of the sealing portion relative to the instrument shaft.

Abstract: Biopsy forceps devices used to obtain tissue samples from a patient using an endoscopic system include larger cup size, longer jaw length, a squared front face, a tapered jaw design, and an offset pivot to enable taking a larger sample size. The forceps include a drive wire attached to the jaws by linkages having pins slidable within slots on the jaws of the forceps, providing the offset pivot point.

Abstract: A biopsy device comprises a probe and a holster. The probe has a distally extending needle including a transverse tissue receiving aperture. A cutter is translatable relative to the needle to sever tissue protruding through the aperture. A thumbwheel is manually operable to rotate the needle to reorient the angular position of the aperture about the longitudinal axis defined by the needle. The thumbwheel is positioned obliquely with the longitudinal axis. A cable driven mechanism in the holster drives the cutter. A rotatable tissue sample holder is coupled with the probe, and has chambers configured to receive tissue samples communicated proximally through a lumen defined by the cutter. A piezoelectric motor in the holster drives the tissue sample holder.

Abstract: Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

Abstract: A flexible auger design for low-torque transmitting drive shafts, which allows effective tissue material transport through curved, flexible tubes and channels. A hollow auger has a hollow center, so that the helical member hugs the inner wall of the tube and material is transported along the center axis and the inner wall of the tube. The hollow flexible auger allows for transportation of material from an operative location in the patient (material removal) as well as to operative location in the patient (material delivery).

Abstract: A surgical device adapter for coupling an end effector to a handle assembly is disclosed. The surgical device adapter includes: a housing including a proximal end couplable to a distal end of a handle assembly; and a drive coupling assembly and selectively couplable to the handle assembly, the drive coupling assembly including a tubular clamping member having at least one flexible member, the tubular clamping member movable from a proximal position in which the at least one flexible member is disengaged from the distal end of the handle assembly to a distal position in which the at least one flexible member is engaged to the distal end of the handle assembly.

Abstract: An apparatus includes a tubular structure having a proximal end, a distal end, and a body extending between the proximal and distal ends, wherein the body includes a lumen for housing at least a part of an imaging device, and a fluid delivery channel that is fixed in position relative to the body, and an opening that is in fluid communication with the fluid delivery channel, wherein the fluid delivery channel has a first portion, and a second portion that forms an angle with an axis of the first portion.

Abstract: A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described, as well as alternative systems for tissue preservation and transport. The cutting device includes an outer cannula in which a reciprocating inner cannula is disposed. A tissue collector is also provided and is in fluid communication with the lumen of the inner cannula. A temperature control sleeve may be disposed around the tissue collector to control the temperature of the tissue samples. A preservation system may be supplied that is configured to deliver fluids to tissue samples in the tissue collector. A fluid supply sleeve may be disposed about the outer cannula and is selectively positionable along the length of the outer cannula.

Abstract: A thrombectomy apparatus for breaking up thrombus or other obstructive material in a lumen of a vascular graft or vessel. The apparatus includes a wire having a first configuration and a second deployed configuration, the wire having a straighter configuration in the first configuration. The wire is operatively connected to a motor for rotation of the wire to contact and break up the thrombus or other obstructive material. A blocking device at a distal portion of the apparatus is movable between a collapsed configuration and an expanded configuration, and is configured in the expanded configuration to block thrombus dislodged by rotation of the wire.

Abstract: A long articulating steerable clip applier affixed to a user-operated handle. A surgical jaw assembly is attached to the other end of the clip applier. The clip applier is composed of articulating phalanges that are connected end to end by pivoting links and capable of angulations relative to one another when subjected to a tensile force. Each phalange has opposing s-shaped exterior grooves that form two continuous spiral-shaped channels for holding tension wires once the phalanges are assembled. Multiple tension wires are attached to opposite ends of adjacent phalanges. When each wire is pulled, this tensile force causes the phalanges to pivot at equivalent angles with each other. As each individual phalange pivots by an equivalent angle, the sum of these angles causes the free end of the clip applier to pivot by a large angle or a cascading actuation effect.

Abstract: Methods, devices, and systems are described herein that allow for improved sampling of tissue from remote sites in the body. A tissue sampling device comprises a handle allowing single hand operation. In one variation the tissue sampling device includes a blood vessel scanning means and tissue coring means to excise a histology sample from a target site free of blood vessels. The sampling device also includes an adjustable stop to control the depth of needle penetration. The sampling device may be used through a working channel of a bronchoscope.

Abstract: A biopsy device includes a cannula and an inner divider wall disposed in the cannula. The inner divider wall defines a plurality of cannula fluid openings. The outer wall of the cannula and the inner divider wall together define a cutter receiving lumen and a cannula vacuum lumen. The cannula fluid openings provide fluid communication between the cutter receiving lumen and the cannula vacuum lumen. A cutter is translatable with respect to the cannula for severing tissue drawn into the cannula. The cutter is operable to cover and/or uncover the cannula fluid openings. A proximal portion of the cutter is spaced away from the inner divider wall. A distal portion of the cutter is configured to slide adjacent to the inner divider wall.

Abstract: An electrosurgical instrument includes mutually movable instrument legs each comprising one or more electrode faces between which tissue can be clamped and treated in electrothermal manner. The movement of the instrument legs relative to each other can be delimited by at least two spacers which are spaced from each other in the longitudinal extension of the instrument legs and act on the instrument legs. At least one electrode face portion subjected to deflection in a closed position of the instrument legs is formed to be bow-shaped, in particular concave, the curvature being contrary to the bending direction to be expected.

Abstract: A surgical instrument includes an end effector assembly having jaw members movable between spaced-apart, first approximated, and second approximated positions. A knife is selectively movable relative to the end effector assembly between a retracted position, a first extended position, and a second extended position. A trigger is selectively actuatable between a un-actuated position, a first actuated position, and a second actuated position for moving the knife between its respective positions. A control member prevents movement of the trigger when the jaw members are disposed in the spaced-apart position, permits movement of the trigger to the first actuated position but prevents movement beyond the first actuated position when the jaw members are disposed in the first approximated position, and permits movement of the trigger to the second actuated position but prevents movement beyond the second actuated position when the jaw members are disposed in the second approximated position.

Abstract: A surgical device includes a first member, deformable to move a pair of opposing projections toward one another. The projections are received in a pair of opposing openings in a second member, so the first member can pivot relative to the second member about an axis defined by the projections. In another aspect, a surgical instrument includes a first pinless joint pivotably coupling a first jaw to a second jaw, a second pinless joint coupling a distal end of an actuating member to the first jaw, and a third pinless joint coupling a handle to a proximal end of the actuating member. The third pinless joint translates movement of the handle into axial movement of the actuating member, and the second pinless joint translates axial movement of the actuating member into pivotable movement of the first jaw relative to the second jaw about the first pinless joint.

Abstract: Devices and methods are provided for adjusting a tissue gap of an end effector of a surgical device. In general, a surgical device can be configured to have an adjustable gap of space between a cartridge jaw and an anvil of the device's end effector when the end effector is in a closed position. The end effector can be configured to removably seat a cartridge therein. The cartridge can be configured to define the gap of space between the cartridge jaw and the anvil when the end effector is in the closed position.

Abstract: A push-to-close actuated, dual-action, spaced pivot, assembly for jaws, blades, and forceps devices. The assembly is structured for use with a push rod, cable, or solid wire forceps actuator surgical instrument. A jaw receiving body of the assembly is adapted to receive a wide variety of types of jaws performing different surgical functions. Two separate moving jaws each pivot about a separate spaced pivot pin, on opposite sides of the jaw body centerline. A handle with a pushing actuating rod provides a pushing motion to a drive rod, cable, or solid wire within a cable sheath to push a connected yoke in the assembly to push against the jaws to close the jaws together.

Abstract: A rotatable jaw device for use with an endoscope. The device includes a fork, and two jaws pivotally mounted to the fork. The jaws are movable between a predetermined closed position and a predetermined open position. At least one jaw has at least one protrusion on a surface of the jaw. The at least one protrusion prohibits movement of the two jaws in the opening direction beyond the predetermined open position.

Abstract: A method comprises receiving a surgical instrument into engagement with a grip actuator of a teleoperational activation system. The surgical instrument includes movable jaws, and the surgical instrument is received in a prearranged gripping configuration with the jaws gripping a surgical accessory. The method includes generating a first control signal for manipulating the surgical instrument while maintaining the surgical instrument in the prearranged gripping configuration. The method further includes generating a second control signal for manipulating the surgical instrument to move from the prearranged gripping configuration to a second configuration.

Abstract: A laparoscopic instrument assembly with a handle member and a removable tip. The handle member and removable tip are mated using a double threaded design which provides a secure connection with low electrical resistance. Electrical energy is provided through an inner shaft to the removable tip, and a return energy path is formed using an outer tubing of the instrument assembly. The removal tip includes a cutting and sealing device with a resistive member that is provided with the electrical energy, thereby enabling the tip to cut and seal tissue.

Abstract: Balloon angioplasty catheters having cutting or scoring members that are moveable in at least one direction between a stowed position (away from the angioplasty balloon) and an operative position (on the angioplasty balloon). A balloon catheter of the present invention alternately useable to perform balloon dilation of a body lumen with and without concurrent cutting or scoring.

Abstract: The present disclosure is a method and apparatus to prepare a tissue tract having a handle member with a centerline, and a scalpel member fixedly attached to the handle member having a blunt tip, wherein the handle member has a first side positioned at a first positive angle relative to the centerline, and a second side opposite the first side positioned at a second positive angle relative to the centerline.

Abstract: Devices and methods are provided for facilitating closing and clamping of an end effector of a surgical device. In general, the devices and methods can be configured to increase a moment arm of the end effector, thereby increasing a closure force of the end effector. In an exemplary embodiment, a surgical device can include a closure mechanism configured to provide an increased moment arm at the device's end effector, such as at a proximal end thereof.

Abstract: This invention is a device designed to deflate rubber rafts, inner tubes, air mattresses and other inflatable objects equipped with cut-check valves or self-closing squeeze valves. The device is constructed of a rigid material, the body of which is comprised of a slender conical shape, terminating in a perpendicular T shaped handle. A tapered air gap runs through the core of the slender conical body along the vertical axis of the device. When inserted into said valves, the smooth rounded tip of the device safely penetrates the cut-check or flap portion of the valve, allowing air to flow from the inflatable object, through the device, and into the atmosphere. The tapered body is compatible with valves of various size diameters. When inserted into said valves, friction ensures the device will remain firmly seated inside said valves allowing hands free deflation.

Abstract: An energy treatment device includes a probe, a sheath unit, a fixed handle, a movable handle unit, a rotation axis, a jaw and a thickness-reduced portion. The thickness-reduced portion is one part of the jaw and is provided between the rotation axis and a distal end of the jaw. The thickness-reduced portion flexes in response to a reaction force when one part of the jaw receives the reaction force from a treatment target due to the opening and closing of the movable handle unit to the treatment target. The thickness-reduced portion prevents the deformation of the other parts of the jaw by flexing.

Abstract: The present invention relates to an instrument and method for passing a medical implement through tissue with magnetic forces. The implement can be an implant, either permanent or temporary, and is provided with a magnetic component. A magnetic field is established and the magnetic component and/or magnetic field is manipulated to drive the implant through tissue. Alternatively, the instrument itself is the implement and includes at least one magnetic element so that a magnetic field established by an external magnetic generator drives the instrument through tissue. In another embodiment, the instrument includes two magnetic elements that are moveable with respect to one another and interaction between the magnetic elements drives the instrument through the tissue. Examples of applications of the present invention include a suture passer and a tissue anchor.

Abstract: There is disclosed, among other things, embodiments of a biopsy needle for taking a full core sample through soft tissue. In the illustrated embodiments, the needle includes a single monolithic tubular member having a notch cut part-way through a distal portion of the tubular member to form an arch-shaped finger. At least a portion of the finger is bent toward the notch and into the lumen of the tubular member. Methods for using these embodiments are also described.

Abstract: A biopsy stylet and needle system is provided that is configured for navigation and spring-loaded deployment through at least one tortuous or otherwise confined length. The system includes a needle cannula through which a notched biopsy stylet is disposed. The notched biopsy stylet includes at least one outer diameter length that is about the same as, but preferably very slightly less than, the inner diameter of the needle cannula. The notched biopsy stylet also includes at least one outer diameter length that has a smaller diameter, the lengthwise position of which corresponds to the tortuous or otherwise confined length through which the system is to be operated. The smaller stylet diameter length is configured to prevent binding between the stylet and the needle cannula and/or between the needle cannula and an overlying access cannula or other access passage structure.

Abstract: A tissue sampling apparatus and method obtain a sample of tissue from a selected site and place a hemostatic plug at the selected site. The apparatus includes an external needle and an internal needle within the external needle. A chamber in the internal needle is divided by a divider member into a plug compartment for receiving a hemostatic plug, and a sample compartment for receiving a tissue sample. The divider member is resiliently biased into the plug compartment and the internal needle is movable relative to the external needle for admitting the hemostatic plug into the plug compartment and displacing the divider member into the sample compartment, and then closing the chamber. The apparatus then is advanced to the selected site where relative movement between the internal and external needles opens the chamber, allowing the divider member to expel the hemostatic plug from the plug compartment, and admitting a tissue sample into the sample compartment.

Abstract: Various surgical devices are provided for shielding tissue from potentially harmful byproducts generated by surgical devices that use energy to treat tissue. In general, a shield member is provided that includes a connector element for removably connecting the shield member to a surgical device and a shield body configured to extend adjacent to an energy-emitting end effector of the device. When energy is delivered to treated tissue captured by the end effector, the shield body can be configured to serve as a physical barrier between the end effector and tissue adjacent to the treated tissue. In this way, the shield member can protect the adjacent tissue from potentially harmful byproducts of the end effector, e.g., heat and steam, and/or can deflect the byproducts back toward the treated tissue.

Abstract: A tissue removal device includes an outer tubular member coupled to a housing and a having a tissue resection window, an inner tubular member slidably disposed within the outer tubular member, a tissue trap having a sealed interior in fluid communication with a vacuum chamber, an open proximal end of the inner tubular member being disposed within the tissue trap interior, and an actuator moveably coupled to the housing and operatively connected to a movable piston in the vacuum chamber, such that movement of the actuator relative to the housing generates a vacuum in the tissue trap.

Abstract: A vitrectomy probe includes a hand-graspable body and an outer tube extending from the hand-graspable body. The outer tube includes a closed distal end and a first port sized to receive tissue. The vitrectomy probe also includes an inner tube within the outer tube with a second port that is selectively alignable with a portion of the first port to allow fluid flow and uniquely sized to increase fluid flow. The inner tube includes a distal tip with a cutting edge on each of the distal and proximal sides of the tip. The distal tip has a smaller diameter than that of the inner tube at a proximal side of the second port. The proximal side of the second port includes a guiding surface that slidably bears on an inner surface of the outer tube to prevent the distal tip from excessively protruding from the first port of the outer tube.

Abstract: An implantable medical device for optically sensing action potential signals in excitable body tissue. The device includes an elongated tubular lead body carrying an optical fiber extending from a proximal lead end to a distal lead end to position the optical fiber at a target site. The lead body additionally carries a conduit for dispensing a voltage-sensitive fluorescent dye into tissue surrounding the target site. The optical fiber transmits excitation light to the fluorescent dye to cause the dye to fluoresce with varying intensity as the transmembrane potentials of local tissue cells vary due to passing depolarization wavefronts. The optical fiber transmits the fluorescence signal to the device to generate an action potential signal or fiducial points of an action potential signal for use in accurately measuring and characterizing electrical activity of excitable tissue.

Abstract: A tissue removal apparatus and needle assembly for extracting a tissue portion from tissue or the like, the needle assembly comprising an inner tube having an interior cavity, an outer cannula having a proximal end, a distal end and an interior cavity, the interior cavity of the outer cannula having an interior diameter to slidably receive the inner tube and a collapsible section operably engaged with the inner tube and the outer cannula whereby a forward movement of a portion of the inner tube within the interior cavity of the outer cannula changes the collapsible section from a neutral position to a collapsed position to engage the tissue portion. In some embodiments, the outer cannula further comprises an aperture configured to allow a tissue portion from within the needle assembly to pass through or otherwise be expelled outside of the needle assembly.

Abstract: A system for image-guided surgery may include a visual imaging system, a medical tool comprising a shaft and a tip, wherein the shaft of the tool includes an optically detectable feature that allows a position of the tip to be determined, and a display configured to display a real-time representation of the medical tool including the position of the tip regardless of whether the tip is obstructed or visible.

Abstract: A method and device for operating an RF surgical assembly for the RF surgical removal of pathological tissue in hollow organs of a patient wherein the RF surgical assembly includes an RF surgical device having an RF generator for generating an RF current and a bipolar loop having two mutually insulated loop sections which can be brought electrically in contact with the tissue and wherein the RF generator has a first and an antipolar second output.

Abstract: A microbiopsy device for taking biological samples, comprising a body including two or more cutting elements for cutting tissue to form a biological sample; and a chamber inside the body for receiving and retaining the biological sample, the chamber having an opening between the cutting elements, wherein the cutting elements are arranged to cut a section of tissue having a width of less than 1 mm.

Abstract: The present invention provides systems and methods for minimally invasive endoscopic surgical procedures. In certain embodiments, the surgical procedures include harvesting of a deep basilic or cephalic vein for creation of a brachial-basilic or brachial-cephalic AV fistula, with simultaneous transpositioning, harvesting of a deep basilic or cephalic vein for transposition of an existing brachial-basilic or brachial-cephalic AV fistula, and ligating and excising an aneurysmal radial-cephalic, brachial-cephalic, or brachial-basilic AV fistula from the upper or lower arm.

Abstract: A biopsy instrument driver includes a drive member having a laterally extending catch arm and movable between a distal, fired position and a proximal, armed position. A reversible motor has a rotatable output comprising or otherwise being operatively connected to a drive shaft, such that activation of the motor rotates the drive shaft. A translating member is threadably coupled to the drive shaft, wherein rotation of the drive shaft causes axial translation of the translating member along the drive shaft. A latch base is operatively associated with the translating member. A latch arm is pivotally coupled to the latch base, and has a distal portion configured to selectively engage and retain the drive member catch arm, and a proximal portion operatively coupled to the translating member, such that movement of the translating member relative to the latch base pivots latch arm distal portion.

Abstract: A vitrectomy probe for removing vitreous material from an eyeball, having a longitudinal axis and an outer tube with a closed end and a lateral surface, at least one inlet port located proximate to the closed end and configured to allow the vitreous material to enter into the outer tube; an inner tube arranged in the outer tube to relatively move with respect to the outer tube, the inner tube having an opening with a cutting profile through which the vitreous material can be cut and can enter the inner tube. A drive unit configured for causing the outer tube and the inner tube to move relatively with respect to each other, in such a way that the cutting profile cuts the vitreous material entering the inlet port.

Abstract: An endoscopic instrument includes an elongate hollow member, an actuator that moves axially through the hollow member, and first and second end effectors with respective tissue engaging edges. At least one of the end effectors is rotatably coupled to the hollow member adjacent its distal end. At least one of the end effectors includes a base supporting a resilient leaf-spring portion that includes a respective cutting edge. The resilient leaf-spring portion extends from the base in a cantilevered arrangement and generates a spring force acting on the respective cutting edge such that in a loaded state there is an automatic preload force imparted between the cutting edges of the end effectors to maintain a consistent and continuous mating force between the two opposed tissue engaging edges preferably over the complete range of rotational movement of the end effectors.

Abstract: A medical manipulator including a base section at which a support surface is formed, a movable part movably supported on the support surface, when a reference direction parallel to the support surface is defined, between a distal end position, which is a distal end side in the reference direction with respect to the base section, and a proximal end position, which is a proximal end side in the reference direction, a positioning mechanism configured to position the movable part at the distal end position with respect to the base section, a holding section movably supported in the reference direction with respect to the movable part and configured to detachably hold a proximal end portion of a treatment tool, and a driving unit configured to move the holding section in the reference direction with respect to the movable part.

Abstract: The invention provides surgical or diagnostic tools and associated methods that offer improved user control for operating remotely within regions of the body. These tools include a proximally-located actuator for the operation of a distal end effector, as well as proximally-located actuators for articulational and rotational movements of the end effector. Control mechanisms and methods refine operator control of end effector actuation and of these articulational and rotational movements. A rotation lock provides for enablement and disablement of rotatability of the end effector. The tool may also include other features. A multi-state ratchet for end effector actuation provides enablement-disablement options with tactile feedback. A force limiter mechanism protects the end effector and manipulated objects from the harm of potentially excessive force applied by the operator.

Abstract: A biopsy system includes a biopsy targeting assembly, a needle, and a biopsy device. The biopsy targeting assembly includes a cradle. The needle is releasably supported by the targeting assembly. The biopsy device includes a body having a tissue collection assembly and a cutter. The cutter is translatable relative to the body and extends distally from the body. The cradle of the targeting assembly releasably supports the body of the biopsy device distally of the tissue collection assembly. The biopsy device translates a distal portion of the cutter within the needle with the needle supported by the targeting assembly.

Abstract: The present invention comprises an improved clamp for securing two members together. The invention includes a pair of clamp jaws that may be positioned in spaced relation to each another and adjusted in three dimensions.