Abstract: Disclosed herein are steerable catheter assemblies and methods of steering catheters that utilize gimbal plate and ring mechanisms to accomplish independent control of catheter flex magnitude and catheter flex direction. Some embodiments include a catheter with two or more pull wires that flex the catheter, a housing connected to the catheter, a gimbal ring pivotally connected to the housing, a gimbal plate pivotally connected to the gimbal ring to form a gimbal assembly, and an adjustment member coupled to the gimbal assembly, such that the adjustment member is movable axially and rotationally relative to the gimbal assembly. The two or more pull wires are connected to the gimbal plate, the adjustment member engages the gimbal plate such that movement of the adjustment member adjusts the position of the gimbal assembly to thereby flex the catheter with the pull wires.

Abstract: A magnet assisted surgical device, system, and method employs magnetic sections, catheters, and guidewires to modify tubular stentgrafts in-situ. One example application provides a more reliable way for surgeons to modify stentgrafts insitu to allow blood flow to continue to branching blood vessels that would otherwise be blocked by the stentgraft itself. One such method includes placing a tip section of the device in the desired location, deploying a stentgraft, placing a magnetic device inside the stentgraft, connecting the magnetic device to the tip section, and excising the portion of the stentgraft held between the magnet and the tip section.

Abstract: A disposable housing includes a housing portion and a memory. The housing portion defines a cavity therein configured to receive a motor operable, inner core handle assembly. At least a portion of the housing portion has a color that corresponds to a color of one type of end effector or adapter assembly. The memory has stored therein at least one operating parameter for the inner core handle assembly.

Abstract: A venous valve incising cutter includes a cutting teeth head, a guide, a wire and a coupling rod that couples the guide and a cutting teeth head, all aligned in a rotation axis thereof. More than four pieces of cutting blades are formed on the outer surrounding surface of the cutting teeth head. Each cutting blade has a roughly triangular pyramid shape such that the three ridge lines are composed of the outer surrounding surface of the cutting teeth head and the two planes formed in the reverse side of the outer surrounding surface and the apex is a knife-point of the cutting blade.

Abstract: Systems and methods are disclosed for assessing tissue contact, e.g., for mapping, tissue ablation, or other procedures. An exemplary tissue contact sensing system comprises a flexible tip device. At least one piezoelectric sensor is housed within the flexible tip device. The at least one piezoelectric sensor is responsive to contact stress of the flexible tip device by generating electrical signals corresponding to the amount of contact stress. An output device is electrically connected to the at least one piezoelectric sensor. The output device receives the electrical signals for assessing tissue contact by the flexible tip device. Methods for assembling and using the flexible tip device are also disclosed.

Abstract: A catheter for thromboembolic disease with mechanic waves, injection, and ejection having a triple-lumen catheter system, whereby a first lumen is for injection, a second lumen is for ejection, and a third lumen has a mechanical wave emitter for wave emissions. The first lumen, the second lumen, and the third lumen are longitudinal, whereby the first lumen and the second lumen are symmetrical and opposite each other, and the third lumen is positioned approximately at a center of the triple lumen catheter system.

Abstract: A probe for ablating tissue of a body cavity includes a shaft, an inflatable balloon connected to the shaft, and an electrode structure on or surrounding the balloon. The balloon expands within the body cavity to place the electrode structure in contact with the tissues in the body cavity. Additional electrodes, which are housed within the balloon during insertion into the cavity, can be extended outwardly from the balloon to penetrate the tissues in the body cavity. The electrode structure and the additional electrodes are adapted to transmit electrical energy to tissue of the body cavity in order to ablate the tissues up to a predetermined depth.

Abstract: A catheter assembly with segmented or step-wise deployment stabilization system includes a base or handle, puncture needle extending from the handle, and a deployment mechanism or mechanisms to selectively extend from the distal end of the needle for first length a hollow stabilizing component and as a second step to a second further length a stabilizing guide wire element. The needle will gain sub-dermal access to the patient to the intended position for deployment of a catheter. Hollow stabilizing component provides for a first additional guide and support for a catheter sheath from the distal end of the needle. The stabilizing wire element provides additional length, guide and support for the catheter sheath. The hollow stabilizing component has some degree of flexibility as does the guide wire to minimize chance of damage to surrounding tissue.

Abstract: A lead assembly includes a lead with a distal end and a proximal end. The lead includes a plurality of electrodes disposed at the distal end and a plurality of terminals disposed at the proximal end. The lead also defines at least one central lumen and a plurality of outer lumens. The central and outer lumens extend from the proximal end to the distal end such that the plurality of outer lumens extend laterally from the at least one central lumen. The lead further includes a plurality of conductive wires. Each conductive wire couples at least one of the plurality of electrodes electrically to at least one of the plurality of terminals. At least two conductive wires are disposed in each of the plurality of outer lumens.

Abstract: A method for performing an inferior lift in a sinus includes preparing an initial opening in a bone including a marrow section and a hard sinus floor, the initial opening being drilled through the marrow section to a depth just prior to reaching the hard floor of the sinus. A portion of the hard sinus floor is removed using a sonic drilling device. Subsequently any remaining doughnut shaped hard floor of the sinus is removed using a second tip on the sonic drilling device that has an active portion that is substantially limited to 360 degrees about the circumference of the forward direction of the tip but without any forward cutting surface, the second tip configured to remove bone only in the lateral direction of the second tip without substantial cutting contact with the marrow section of the bone clearing a widened opening in the hard sinus floor of the bone.

Abstract: A clot retrieval device, for example to be used in a thrombectomy, is provided including a catheter, an elongated member, and a knitted basket with a proximal end coupled to the catheter and a distal end coupled to the elongated member. The elongated member is movable between an expanded position and a compressed position relative to the catheter and is configured so that the knitted basket expands radially and compresses as the elongated member is moved to the compressed position. The knitted basket is comprised of a plurality of wires coupled together by a plurality of windings. Each winding comprises one of the plurality of the wires twisted about another of the plurality of wires.

Abstract: An example thrombectomy device is disclosed. The example thrombectomy catheter includes a catheter tube including a proximal portion, a distal portion and a lumen extending therein. The thrombectomy catheter also includes a high pressure tube extending through the catheter lumen from the catheter proximal portion toward the catheter distal portion, the high pressure tube having at least one jet orifice for directing at least one fluid jet through the catheter lumen. The thrombectomy catheter also includes an outflow orifice, an inflow orifice and a fluid pulse generator coupled to the proximal portion of the catheter tube, wherein the fluid pulse generator is configured to inject fluid though the thrombectomy catheter at a first frequency.

Abstract: A method and apparatus for delivering energy during a surgical procedure such as phacoemulsification is provided. The method and apparatus include applying energy during at least one pulsed energy on period, typically sufficient or intended to rapidly induce and beneficially employ transient cavitation. Applying energy during the pulsed energy on period comprises applying energy during a first high energy period, and applying energy during a second nonzero lower energy period.

Abstract: Extension attachments selectively couple to any of a variety of hand held instruments. The extension attachments may include smoke evacuation shafts and electrosurgical electrodes. The extension attachments may extend the functional capabilities of the hand held instruments, such as electrosurgical and smoke capture capabilities.

Abstract: An atherectomy catheter directs particles generated by a cutting element into a collection chamber. A lumen configured to direct fluid into the tissue collection chamber.

Abstract: An aspiration system includes a pump and a control system in communication with the pump. The control system includes a microcontroller, an antenna configured to receive a signal, and a pump control board in communication with the microcontroller. The antenna is in communication with the microcontroller. Upon receiving the signal, the pump control board operates the pump to create negative pressure according to the signal.

Abstract: Ocular surgery may be performed by a variety of systems, processes, and techniques. In certain implementations, systems and processes for ocular surgery may include the ability to emulsify a lens in an eye using a modular hand-held system including a phacoemulsification unit detachably coupled to a pump unit and remove lens portions from the eye using suction provided by the pump unit. The system and the process may also include the ability to decouple the phacoemulsification unit from the pump unit, couple an irrigation-aspiration unit to the pump unit to form a second hand-held system, and remove material from the eye using suction provided by the pump unit.

Abstract: A medical elongated body is disclosed, which is able to make a nick in a stenosed site and is capable of preferably widening the stenosed site in which the nick is made. A balloon catheter is disclosed, which includes a shaft, a dilation member that is fixed to the shaft on a distal side, and an elastic member that is disposed on an inner surface of the dilation member. The dilation member includes a projection portion, which is a part of the dilation member protruding in a radial direction due to the elastic member disposed at a position where the inner surfaces of the dilation member face each other. A material of the elastic member is configured to be a material, which is further stretched than a material of the dilation member in a circumferential direction when the dilation member dilates.

Abstract: Systems, apparatuses, and methods of and for an ophthalmic surgical system are disclosed. An ophthalmic surgical system may include a vitreous probe having a housing sized and shaped for grasping by a user. The vitreous probe may also include a cutter extending from the housing and being sized to penetrate and treat a patient eye. The cutter may include an outer cutting tube coupled to the housing. The outer cutting tube may have an outer port formed at a distal end wall of the outer cutting tube and configured to receive tissue. The cutter may include a rotatable inner cutting member disposed within the outer cutting tube. The inner cutting member may include a first cutting surface that rotates across the outer port to cut the tissue when the inner cutting member is rotated.

Abstract: An electrosurgical device having a handpiece including a controller and an electrode assembly extending from the handpiece is disclosed. The electrode assembly includes a monopolar blade and a monopolar electrode. The monopolar blade includes a conductive element partially coated with an insulator and electrically coupled to the controller to selectively deliver a monopolar radiofrequency (RF) cutting signal. The monopolar electrode is spaced apart and electrically isolated from the monopolar blade. The monopolar electrode includes an exposed major conductive surface electrically coupled to the controller to selectively deliver a monopolar RF hemostatic sealing signal with a dispersed fluid.

Abstract: Disclosed is a system to engage one or more tools. In the system a drive shaft and collet may be assembled to engage and disengage, selectively, a plurality of tools. Further, a tracking device may be used to track a location of at least a portion of the tool.

Abstract: A surgical apparatus includes a debriding device, a hollow tube, and an irrigation assembly. The debriding device is fitted at a distal end of the surgical apparatus and is configured to debride tissue from a debriding site in a patient body. The hollow tube is configured to evacuate the debrided tissue away from the debriding site. The irrigation assembly is configured to apply irrigation fluid, via one or more orifices formed in the hollow tube, to the debrided tissue being evacuated.

Abstract: A microneedle unit including a microneedle including a substrate having a first surface and a second surface opposite to the first surface, the microneedle further including a projection protruding from the first surface of the substrate, an adhesive sheet including a sticking region attached to the second surface, the adhesive sheet further including an adhesive region protruding outside the substrate from the sticking region in a direction parallel to the second surface, and a protective sheet covering a portion of the adhesive region outside of the substrate in the direction parallel to the second surface.

Abstract: A fracture in a hollow bone is supported temporarily by a rigid plastics implant formed within a balloon within the bone. To assist implant removal, an access port, comprising a hollow cylinder, is inserted through an aperture made in an end of the bone and surrounds a proximal end of the implant. The access port is connected to a source of torsional-mode ultrasonic vibrations to soften the plastic implant and improve engagement between access port and implant. Removal of the ultrasound source allows introduction of a cutting tool through the access port, which guides it to hollow out the implant. The implant then collapses within the balloon and is withdrawn through the access port. One suitable cutting tool has a head with four helical fins separated by part-circular grooves and a concave distal face. Ultrasonically activated, the fin tips soften and cut the plastic, which flows away along the grooves.

Abstract: A surgical tool that includes a drive housing, an elongate shaft that extends from the drive housing, and a plurality of drive cables extending within the elongate shaft between the drive housing and an end effector coupled to a distal end of the elongate shaft. A cable brake assembly is at least partially arranged within a cavity defined in the drive housing or the elongate shaft, the cable brake assembly having one or more brakes and a brake pad engageable with one or more of the plurality of drive cables. The cable brake assembly is actuatable between a first position, where the plurality of drive cables are free to move longitudinally within the elongate shaft, and a second position, where the one or more brakes and the brake pad engage and prevent the one or more of the plurality of drive cables from moving.

Abstract: A surgical apparatus includes a rotatable shaft and a turbine assembly. The rotatable shaft includes a cutter located thereon. The cutter is configured to cut an object when the shaft is rotating about a rotational axis. The turbine assembly includes a turbine and a turbine housing. The turbine housing is configured to receive a fluid that enters the housing parallel to the rotational axis, and to steer the fluid to impinge on the turbine in a direction that is not parallel to the rotational axis. The turbine is configured to rotate the shaft so as to cut the object by the cutter.

Abstract: An improved catheter atherector for shaving, cutting, and emulsifying accumulated plaque into fine particles, and removing the particles from blood vessel walls without cutting or permanently stretching the walls, and without substantially blocking the blood flow through the vessel during plaque removal operation. The catheter atherector includes an emulsification reduction sphere and extraction wire that rotate and move axially inside the vessel to engage the occlusive material. Emulsified occlusive reduced plaque material and blood only flow in a proximal direction into a catheter lumen. The operation of the device does not substantially disrupt blood pressure within the blood vessel.

Abstract: The present disclosure provides description of applicators to implement modular magnetic anastomosis device. In one embodiment the delivery device is a laparoscopic instrument for MISS surgery, in another embodiment the delivery device is endoscopy or colonoscopy instrument for NOTES surgery.

Abstract: This disclosure disclosed an ultrasonic needle and apparatus used for removal of the vitreous body and other tissues. An ultrasonic vitrectomy needle, comprising: a connector, a connected inner needle, and an outer sheath. The length of the outer sheath at the distal end is slightly longer than that of the inner needle; the sheath distal end is of blind with smooth surface, but there is an open cut at the side of the distal end used for aspirating the vitreous body.

Abstract: A cannula for a surgical system may include a magnet located in a position to be sensed by the surgical system in a mounted position of the cannula to the surgical system. At least one of a presence of the magnet and a polarity of the magnet is sensed in the mounted position of the cannula to provide identification information relating to the cannula. Exemplary embodiments further encompass a patient side cart for a teleoperated surgical system, the patient side cart including a base, a main column, and an arm connected to the main column. The arm may include a mount to receive a cannula and a reader to sense a magnet of an identification device in the cannula so as to receive identification information relating to a mounted cannula.

Abstract: A blade assembly comprising: a tip including two or more tubes, wherein the two or more tubes include at least: an outer tube and an inner tube; and a mechanical enclosure including: a locking spline having a longitudinal axis; and a slide lock; wherein the slide lock slides along the longitudinal axis of the locking spline and over the locking spline forming a locked state so that rotational movement of the locking spline, around the longitudinal axis of the locking spline, is prevented; and wherein the outer tube is coupled to the locking spline so that rotational movement of the outer tube, around the longitudinal axis of the locking spline, is prevented during the locked state.

Abstract: Tissue can be removed from a patient with a catheter or other medical device having a cutting member. A source of suction can be coupled to the device for suctioning removed tissue through a lumen in the device and out of the patient's body.

Abstract: The present technology provide compositions that are drug delivery systems for the sustained release of anti-stenotic drugs for the treatment and prevention of occlusion of blood vessels, particularly after perivascular surgery. The compositions include a hydrogel, unimolecular micelles dispersed within the hydrogel, and an effective amount of anti-stenotic drug dispersed within the unimolecular micelle. The hydrogel may be a di-or tri-block copolymer comprising one block of poly(ethylene glycol) (PEG) and one or two blocks of poly(lactic-co-glycolic acid) (PLGA). The unimolecular micelle may include three domains: a dendritic polymer core, hydrophobic block polymers (e.g., PVL, PVCL, and/or PCL) attached to the core and PEG attached to the hydrophobic block polymers.

Abstract: A phacoemulsification needle has a polygonally-shaped tip with an axis that is offset from the axis of the needle body. The material forming the tip is non-uniformly distributed, adding to the motion of the tip when it is vibrated torsionally. In one embodiment, the tip has tip wall segments of varying thicknesses. In another embodiment, the tip has a series of external ribs formed on the tip wall segments, on the wall segment, at the apex where adjacent wall segments meet, or both.

Abstract: A medical instrument (1) designed in particular as an endoscope (2) has a main body (3) and, formed on the main body (3), an electrical and/or electronic switching device (4) with at least one button (5) for actuating the switching device (4) and the medical instrument (1). The switching device (4) is provided on its outside (6) with a cover (7), which is integrally bonded to the main body (3) of the medical instrument (1) in order to produce a tight connection. Provision is further made that the cover (7) has at least one outwardly directed bulge (8), on which the at least one button (5) of the switching device (4) is formed.

Abstract: A method of aspirating a vascular occlusion from a remote site is provided. The method includes the steps of advancing a first elongate tubular body through a vascular access site and into a body vessel, advancing a second tubular body distally to extend beyond the first elongate tubular body to reach the remote site, and aspirating thrombus from the site into the lumen by applying pulsatile vacuum to the first elongate tubular body. The second tubular body has a lumen and a length that is shorter than the first elongate tubular body. The pulsatile application of vacuum may cause the distal tip of the second tubular body to open and close like a jaw, which facilitates reshaping the thrombus or biting or nibbling the thrombus material into strands or pieces to facilitate proximal withdrawal under negative pressure through the lumen of the second tubular body.

Abstract: Provided is a medical device designed to be inserted into a lumen of a living body, the medical device including: a long shaft part; and a cylindrical hollow body. The shaft part has a center axis at position which differs from a center axis of the hollow body on a cross section perpendicular to the center axis of the shaft part. The hollow body has a housing part extending along the center axis of the hollow body, the hollow body being a groove depressed from an outer peripheral surface to an inner peripheral surface or a slit penetrating from an outer peripheral surface to an inner peripheral surface. The shaft part is positioned between inner surfaces facing from the outer peripheral surface to the inner peripheral surface in such a way that at least a portion of the shaft part constitutes the slit or the groove of the housing part.

Abstract: Devices, systems and methods for cutting and sealing of tissue such as bone and soft tissue. Devices, systems and methods include delivery of energy including bipolar radiofrequency energy for sealing tissue which may be concurrent with delivery of fluid to a targeted tissue site. Devices include debridement devices which may include a fluid source. Devices include inner and outer shafts coaxially maintained and having cutters for debridement of tissue. An inner shaft may include electrodes apart from the cutter to minimize trauma to tissue during sealing or hemostasis. Devices may include a single, thin liner or sheath for electrically isolating the inner and outer shafts.

Abstract: A first tubular body having a first longitudinal axis extending centrally through the tubular body includes at least one delivery port extending through a wall of the first tubular body. A second tubular body having a second longitudinal axis extends through the second tubular body, the first and second longitudinal axes being displaced from each other such that an asymmetrical longitudinally extending gap is formed between an outer surface of the second tubular body and an interior surface of the first tubular body. A temperature sensor forming a thermocouple extending longitudinally within the gap between the first tubular body and the second tubular body. An inner core is positioned within the second tubular body. The inner core includes least one ultrasound element.

Abstract: The present technology is directed generally to devices, systems, and methods for capturing and cutting fibrous and trabeculated structures (such as synechiae) in vessel lumens. In one embodiment, the present technology includes an intraluminal tissue modifying system configured to capture the fibrous structures, put the fibrous structures in tension, and controllably cut through the fibrous structures without applying appreciable additional force to the vessel wall. The system may include an expandable capture device and a cutting device.

Abstract: The present disclosure describes systems and methods for pressure-driven micro-surgical tool actuation. The systems and methods may encompass the use of a remote handle held by a first hand of a user as well as a surgical tool located in the eye of a patient. A primary actuator may be included in remote handle and operable to be actuated by a mechanical force exerted on the handle. Actuating the primary actuator pressurizes a fluid within a length of tubing. The pressurized fluid may be transmitted to a dynamic tool held by a second hand of the user, where the pressurized fluid may be used to actuate a subordinate actuator. Actuation of the subordinate actuator may actuate a dynamic component of the dynamic tool.

Abstract: Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating an abrasive element within the vessel. The abrasive element can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly. In particular embodiments, the handle assembly includes a compressed gas driven turbine member that drives rotation of the drive shaft. The turbine member can be rotatably attached to a carriage that is longitudinally translatable in relation to a housing of the handle assembly. The handle assembly can include a latch mechanism that when actuated allows the carriage to translate to a proximal-most position. While the carriage is in the proximal-most position, an open pathway is created so that a guidewire can be slidably passed through the handle assembly and a lumen of the drive shaft.

Abstract: An intracorporeal pressure shock wave device to provide treatment within blood vessels artificial vessels and grafts that includes a frontal pressure shock wave reflector positioned at the distal end of an intracorporeal catheter to direct shock waves toward a treatment target, such as an occlusion and clot.

Abstract: An intravascular delivery system includes a threaded coil. The threaded coil includes one or more wires coiled to form a spiral coil with at least one thread extending along a length of the threaded coil. The threaded coil is elastically deformable for delivery of the threaded coil to a target location in the body and is rotatable to longitudinally position an intravascular device at the target location.

Abstract: An ultrasonic element comprises an ultrasonic transducer and a head or blade. The ultrasonic transducer is operable to convert electrical power into ultrasonic vibrations. The head or blade is in acoustic communication with the ultrasonic transducer such that the ultrasonic transducer is operable to drive the ultrasonic blade to vibrate ultrasonically. The head or blade has a curved distal face. The curved distal face defines a proximally extending concave curve. The transducer and head or blade may be driven using a control logic that is configured to cause the ultrasonic transducer to generate a first vibration set followed by a second vibration set. The first vibration set is configured to generate microbubbles in a fluid. The second vibration set is configured to grow microbubbles generated by the first vibration set. The control logic may provide a pause between the first vibration set and the second vibration set.

Abstract: A catheter assembly includes a catheter; a catheter hub fixed to a proximal end portion of the catheter; a hollow needle having a needle tip and disengageably located in the catheter; a needle hub fixed to a proximal end portion of the needle; a guide wire slidably located in the needle, the guide wire being longer than the catheter and having a distal end that is protrudable from the needle tip; a guide wire hub configured to support the guide wire and move the guide wire with respect to the needle in association with movement of the guide wire hub; and a movement mechanism configured to retract the guide wire hub with respect to the needle hub such that the distal end of the guide wire is housed in the needle in association with forward movement of the catheter hub with respect to the needle hub.

Abstract: A device (10) for repair of a heart valve leaflet includes an elongated body (12) having a lumen (16) extending therethrough in a longitudinal direction, a proximal end, an open distal end (19). A core (11) is disposed within the lumen, and is operable to spin about an axis extending in the longitudinal direction. The spinning of the core draws a portion of the heart valve leaflet into the lumen through the open distal end of the body and secures the portion of the heart valve leaflet to the core in a gathered configuration.

Abstract: A hand-held aspiration device is provided which has a relatively small suction volume along a suction path to improve responsiveness of the aspiration device when the device is activated. The device may be manually powered and may be provided without electronic controls. The device has a suction path which may be purged into a disposal enclosure to reduce the volume of material under the influence of the suction pressure during the procedure. The suction source may also be part of the hand-held unit to further reduce the suction path and suction volume.

Abstract: The present invention is directed to an apparatus and method for assisted removal of the cortex, capsule polishing and destruction and/or removal of other intraocular structures. More particularly, the present invention is directed to a surgical apparatus configurable for removal of the cortex and the polishing of the capsule during cataract extraction surgery.

Abstract: An intravascular device is provided having a catheter tube and an expandable portion including a plurality of struts capable of being moved between an open and a closed position. An incising element is provided on at least one of the struts and has a sharpened edge for creating an incision in atherosclerotic material located within a blood vessel when the expandable portion is in the opened position. A medication delivery device may be located on one or more of the struts and may be configured to deliver a substance to an area of interest.