Abstract: An ultrasonic instrument includes a body, an actuation assembly, a shaft assembly, and an end effector. The actuation assembly includes a mode selection member and an activation member. The shaft assembly extends distally from the body. The shaft assembly includes an acoustic waveguide. The end effector includes an ultrasonic blade. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The end effector is configured to be activated in a first activation mode in response to actuation of the activation member when the mode selection member is in a first position. The end effector is configured to be activated in a second activation mode in response to actuation of the activation member when the mode selection member is in a second position.

Abstract: A rotary shaver for tissue resection includes an elongated outer tubular member, an elongated inner cutting member disposed in and operatively rotatable relative to the outer tubular member for cutting a tissue, and an elongated jaw member disposed in the outer tubular member to surround the inner cutting member and operatively turnable to cooperate with an outer distal portion of the outer tubular member so as to clamp and electrocauterize the tissue for creating hemostasis during a surgical procedure.

Abstract: A cage can be positioned around a medical balloon, such as an angioplasty balloon, to assist in a medical procedure. The cage can include a plurality of strips, each extending between a set of rings including first and second rings. As the balloon expands, the first and second rings move closer together and allow the strips to expand outward. The cage may have wedge dissectors on the strips.

Abstract: A device for intra-vascular embolic-thrombolic protection, as well as embolectomy/thrombectomy and atherectomy interventional procedures and methods. At least a portion of the working end of the device may be formed monolithically from a single hypodermic tube, or may be formed of monolithic inner and outer tubes with fixed or movable guide wire elements and imaging modalities. The device may comprise structures enabling coring, expansion within a vascular structure and vascular wall shaving, as well as filtration, stabilization and capturing of thrombotic or embolitic material during an intervention procedure.

Abstract: A catheter is provided with a collection chamber located between a seal and a cap. The seal is located distal from the collection chamber, and the cap is located proximal from the collection chamber. The seal may be opened and closed to alternately allow the passage of material into the collection chamber and prevent fluid from escaping from the shaft lumen. The cap may be opened and closed to allow the removal of a mass from the collection chamber and to prevent fluid from escaping during collection of the mass.

Abstract: The present disclosure is directed to a user interface for modifying preprogrammed relationships between a plurality of subsystems of a surgical system. The user interface may be presented on a system display screen. It includes one or more selectable triggering events shown on the display screen, with each of the one or more selectable triggering events identifying a subsystem condition that selectively occurs during a surgical procedure performed with the surgical system. The interface also includes a plurality of selectable responses to the one or more selectable triggering events. The selectable responses deviate from the preprogrammed relationships between subsystems of the surgical system.

Abstract: An apparatus is configured to provide hemostasis with tissue removal in order to inhibit one or more of blood loss or tissue drainage. In many embodiments, a nozzle releases a liquid jet in a liquid medium in order to provide cavitation and a plurality of shedding pulses. The liquid jet, its cavitation and the plurality of shedding pulses can affect vascular tissue in order to promote clotting in order to inhibit bleeding. In many embodiments, vessels of the vascular tissue are affected at a distance from a region where cavitation of the water jet contacts the tissue. In many embodiments, the cavitation and plurality of shedding pules are related to a pulsatile shear wave propagating along the blood vessel that is related to clot promoting changes of the blood vessel.

Abstract: A device for creating a void space in living tissue includes a handle from which a shaft extends. A tip is moveably attached to the distal end of the shaft. The angular position of the tip is controlled by the rotation of a knob mounted to the handle. The knob is mounted to the handle to project beyond opposed side surfaces of the handle and a surface that bridge between the side surfaces.

Abstract: An apparatus, comprising: a biopsy needle having a distal end and a proximal end, all or a portion of the biopsy needle being movable between a collapsed state and an expanded state; a sheath having a distal end and a proximal end, wherein the biopsy needle in the collapsed state is contained within the sheath, and in the expanded state at least the distal end of the biopsy needle extends from the distal end of the sheath; wherein the biopsy needle is provided with two or more sleeves, which at least partially overlap in the collapsed configuration and which cylindrically expand to provide an increased radius, relative to a radius in the collapsed state, for sampling in the expanded configuration, and wherein a cross section of the distal end of the biopsy needle in the expanded state is a substantially circular cross section.

Abstract: The teachings herein relate to devices for insertion into a cavity, opening or other passageway that requires the bending of the device to conform to a curved or even tortuous shape of the path. The devices include axial support components for translating forces for moving the device forward in the path. The axial support components preferably include adjacent components capable of rocking for tilting the device in one or more directions. The device preferably includes one or more lateral support components for limiting any lateral motion of an axial support component relative to an adjacent axial support component.

Abstract: Thrombectomy systems and devices and methods of using the same. In an exemplary embodiment of a thrombectomy system of the present disclosure, the thrombectomy system comprises a thrombectomy sheath, comprising a circumferential outer wall reinforced with a reinforcement, configured as an elongated tube having a lumen therethrough; and a sonovisible element positioned at or near a distal end of the circumferential outer wall; wherein the thrombectomy sheath is sized and shaped to be at least partially positioned within a vein proximal to a thrombus or other item within the vein and further configured to expand to contact the vein to secure the thrombectomy sheath within the vein; and wherein the lumen is sized and shaped to receive a device selected from the group consisting of a balloon catheter and a snare having a loop.

Abstract: An atherectomy device for removing deposits such as plaque from an interior of a vessel including an outer member and a rotatable shaft positioned for rotational movement within the outer member. The outer member is fixed axially. A rotatable tip is mounted to the distal region of the rotatable shaft for rotation about its longitudinal axis upon rotation of the shaft. The rotatable shaft includes a guidewire lumen for receiving a guidewire to enable over the wire insertion of the device.

Abstract: The invention relates to a method for producing a body implant comprising the steps of: providing a wire; producing predetermined cuts of the cross section of the wire by means of an ultrashort pulse laser in order to produce a predetermined shape of the body implant. This method can be used to produce, for example, a body implant, an assembly consisting of a guide wire and a body implant, or a medical instrument having a guide wire.

Abstract: A system and associated method for altering or destroying tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders. In one aspect, the system includes a device configured to deploy devices for altering the lobes of a prostate.

Abstract: The present invention relates generally to devices and methods for retrieving or manipulating objects within a lumen. More specifically, embodiments of the invention relate to devices and methods for retrieving or manipulating medical devices from a body lumen. One embodiment of the present invention provides a novel and improved retrieval snare and method of fabricating and using the same. The snare includes a snare wire, having a distal end and a proximal end, for use in the human anatomy, such as but not limited to blood vessels, pulmonary airways, reproductive anatomy, gastrointestinal anatomy, and organs such as the kidneys or lungs. The device enables a user to capture a foreign object located within the human anatomy, grasp said object in a controlled manner, and retrieve and remove said object from the human anatomy.

Abstract: A method for identifying a ureter during a medical procedure, the method comprising: providing an electrical stimulator comprising: a shaft having at least one electrode; and a power supply connected to the at least one electrode for providing an electrical signal to the at least one electrode; advancing the shaft so that the at least one electrode contacts tissue; operating the power supply so that the electrical signal is applied to the tissue; and visually observing the tissue to determine the presence of a ureter in the tissue.

Abstract: A memory alloy is used during manufacture of a transducer. The memory of the alloy may correct for deviations or bending during manufacture, such as a superelastic alloy returning an array to a flat state after being twisted during handling. The memory of the alloy may cause a desired change in array geometry during manufacture, such as a shape memory alloy twisting an array into a curved or helix due to applied heat. The array may be fixed in place by the memory alloy or bonding after positioning by the memory alloy, preventing further substantial alteration.

Abstract: An applicator configured for cell treatment with pressure pulses has a hollow needle with a wall, which encloses a cavity and has a closed-off design at a closed-off end. A target is arranged or formed at the closed-off end on the inner side of the wall and a laser radiation emitter for emitting preferably pulsed laser radiation is arranged in the cavity of the hollow needle, at a distance from the target. The laser radiation emitter is arranged so that the emerging laser radiation impinges directly on the target through an interspace situated between the laser radiation emitter and the target. Under the formation of a plasma, at least one pressure pulse can be generated at the target by the target being impinged upon by laser radiation from the laser radiation emitter. The wall of the hollow needle has a lateral emergence opening for the emergence of the pressure pulse.

Abstract: A rotational atherectomy device including a drive shaft rotatably extending through an outer tubular member to rotate a cutting member positioned at a distal end thereof. The rotational atherectomy device further includes an elongate penetrator extendable distal of the cutting member a predetermined maximum distance and configured to stabilize the cutting member as the cutting member engages an occlusion to control the trajectory and advancement of the cutting member through the occlusion.

Abstract: Disclosed is a hyperhidrosis treatment apparatus including a contact part which is detachably mounted and gets in contact with a user's skin so that the contact part can be easily replaced with a new one.

Abstract: A cyclic aperture flow regulator system has an adjustable fluid aperture in a fluid path connecting the aspiration port of a surgical probe with a vacuum source. The cross-sectional area of the fluid aperture can be modified by an actuator. The actuator is controlled to modify the cross-sectional area of the adjustable fluid aperture in cycles. During each cycle, the fluid aperture cross-sectional area is substantially reduced or closed. The cycles occur at a rate fast enough to produce a substantially steady flow, with minimum flow ripple and pressure ripple.

Abstract: An ultrasonic tool or instrument has a probe shaft with a linear proximal end portion and a linear distal end portion disposed at an angle relative to one another and joined at a bend in the shaft. A coupling is provided at a proximal end of the shaft for connecting the probe to a source of ultrasonic vibrational energy. A head provided at a distal end of the shaft extends eccentrically in a transverse direction to one side of the shaft. The head has an operative tip spaced laterally from the axis and is formed with at least one cutout for reducing mass of the head and concomitantly eccentric mass of the probe. The tool or instrument has at least one interior antinode along the shaft and the bend is located substantially distally of the antinode.

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: A tissue resector includes an outer cannula with a cutting wire disposed therein. The outer cannula includes an opening that is configured to be associated with a cutting element of the cutting wire in such a way that when tissue is drawn into the opening of the cannula, a cutting element of the cutting wire can be rotated past the opening to engage and cut into and through the tissue. The outer cannula and the cutting wire may also be configured to enable aspiration of the tissue. A tissue resector according to this disclosure may be used with a hand-held, hand-operated rooter.

Abstract: An ultrasonic catheter includes a body and an ultrasound transmission member disposed in the body. A head is coupled to the ultrasound transmission member, wherein a gap separates the head from a body distal end. A guidewire tube extends through the body and the head. A proximal end connector assembly includes a hub and an absorber member. The hub has a bore coupled to and in fluid communication with the body. The absorber member is disposed within the bore around the ultrasound transmission member. A sonic connector is disposed between the ultrasound transmission member and a separate generator.

Abstract: A device for removing a stone, a stone fragment, or a foreign body from a patient comprising a suction evacuation assembly which includes a primary sheath with a flexible end, an obturator releaseably secured to the sheath, a side arm emanating from the primary sheath, a deflection mechanism which is operationally associated with the flexible end of the sheath and a secondary sheath with a dual lumen and an oblong shape wherein the dual lumen allow passage of surgical instruments and irrigation fluid and wherein the oblong shape provides for adequate space for the egress of stone fragments and fluid through the primary and/or secondary sheath, wherein the obturator is withdrawn from the primary sheath and the secondary sheath is inserted into the primary sheath and into the patient in order to facilitate the removal of the stone, stone fragment or foreign body.

Abstract: An ultrasonic surgical instrument includes a cooling system having a blade conduit disposed within the blade and a cooling fluid. The cooling fluid configured to absorb heat from the blade as the cooling fluid flows through the blade conduit. A surgical system having an ultrasonic surgical instrument and a cooling system is also disclosed. The cooling system can include a fluid control system that automatically pumps a cooling fluid through a blade conduit disposed within the blade of the surgical instrument based on feedback received from sensors.

Abstract: A biological tissue cutting and fluid aspiration system provides a plurality of surgical instruments operable independent of an external control console. In some embodiments, each surgical instrument may include all sensors and controls directly applicable to the surgical instrument, and may be used independently. In some embodiments, instruments communicate status information to each other, and adjust operating parameters based on the communications.

Abstract: A system including a console and a catheter assembly. The console may include an ultrasound-producing mechanism configured to convert an electric current into a vibrational energy. The console also may include a driving-parameter modifier configured to modify driving parameters to selectively provide one or more output modes for the vibrational energy. The catheter assembly may include a sheath including a sheath lumen and a core wire at least partially disposed within the sheath lumen. The core wire may include a proximal portion and a distal portion of the core wire, wherein the proximal portion of the core wire is coupled to the ultrasound-producing mechanism. A working length of the distal portion of the core wire beyond the sheath may be configured for longitudinal, transverse, or longitudinal and transverse displacement in accordance with the one or more output modes for the vibrational energy to effect different intravascular lesion-modification procedures.

Abstract: Provided herein are expanded allogeneic adipose tissue-derived stromal stem cells for use in treating complex perianal fistulas in Crohn's Disease.

Abstract: A treatment of a medical difficulty associated with the formation or presence of a blood clot in a blood vessel, commonly known as “thrombectomy.” Said treatment may be achieved by introducing and positioning through a single lumen a device capable of macerating, irrigating and aspirating as well as supporting structures proximal to the distal end of said device. Said device is introduced via a blood vessel, and deployed at a treatment site. The macerator is then operated to dislocate thrombus, clot, or other occlusive materials at the target site, the irrigating element is then operated to continue to dislocate thrombus, clot, or other occlusive materials at the target site, and the aspirating element is used to collect and remove the disruptive materials from the target site.

Abstract: Various medical devices are described herein. More particularly, various probes used for performing lithotripsy and methods of performing lithotripsy are described. In an example, a probe comprises an elongate member comprising a proximal end, a distal end, a proximal portion, an intermediate portion, and a distal portion. The proximal portion has an outer diameter that is greater than the outer diameter of the distal portion.

Abstract: One embodiment of the invention provides a variable pitch impeller for a blood pump. The variable pitch impeller includes: a flexible polymer defining a plurality of blades extending from a first end to a second end, the blades having a resting non-zero pitch; an external shaft coupled to a first end of the flexible polymer; and an internal shaft received within the external shaft and coupled to the second end of the flexible polymer. The internal shaft and the external shaft are rotatable with respect to each other to achieve a blade pitch between about 0.0001° and about 2,880°.

Abstract: A method and apparatus for chemically treating a cataract in the eye of a patient comprising the steps of (a) inserting a dual lumen work tip into the eye and placing it adjacent the cataract tissue; (b) causing the work tip to vibrate so that pieces of the cataract separate or emulsify; (c) moving the work tip into the cataract tissue so as to form a tunnel therein; and (d) injecting into the tunnel a pharmaceutical compound capable of treating cataract tissue.

Abstract: Disclosed herein is an intravascular device for removing thrombosis and recovering a blood flow, wherein the attachment of thrombosis can be facilitated since a plurality of minute protrusions are formed on the surface of the stent structure. The present inventive concept is able to significantly minimize any separation of the thrombosis when the device for removing thrombosis and recovering a blood flow is transferred to the outside of a human body in such a way that a plurality of minute protrusions are formed on the surface of the stent structure, and the attachment of the thrombosis to the stent can be facilitated.

Abstract: Vascular treatment devices and methods include a woven structure including a plurality of bulbs that may be self-expanding, a hypotube, for example including interspersed patterns of longitudinally spaced rows of kerfs, and a bonding zone between the woven structure and the hypotube. The woven structure may include patterns of radiopaque filaments measurable under x-ray. Structures may be heat treated to include various shapes at different temperatures. The woven structure may be deployable to implant in a vessel. A catheter may include a hypotube including interspersed patterns of longitudinally spaced rows of kerfs and optionally a balloon. Laser cutting systems may include fluid flow systems.

Abstract: A treatment of a medical difficulty associated with the formation or presence of a blood clot in a blood vessel, commonly known as “thrombectomy.” Said treatment may be achieved by introducing and positioning through a single lumen a device capable of macerating, irrigating and aspirating as well as supporting structures proximal to the distal end of said device. Said device is introduced via a blood vessel, and deployed at a treatment site. The macerator is then operated to dislocate thrombus, clot, or other occlusive materials at the target site, the irrigating element is then operated to continue to dislocate thrombus, clot, or other occlusive materials at the target site, and the aspirating element is used to collect and remove the disruptive materials from the target site.

Abstract: Embodiments of the present invention are directed to ablation catheter systems configured, for example, to ablate tissue adjacent an ostium of the pulmonary vein in a left atria of a heart. In one embodiment, an ablation catheter system includes a handle and a catheter coupled to the handle defining a lumen extending through a length of the catheter, the catheter including a distal end thereof. The ablation catheter system may also include an electrode coupled to the handle with lines extending through the lumen of the catheter, the electrode being configured to be constrained adjacent the distal end of the catheter and configured to be deployed from the distal end of the catheter to an expanded configuration.

Abstract: An ultrasonic surgical instrument includes a waveguide defining a blade at a distal end thereof and a lumen extending through a portion of the blade. The blade is configured to receive ultrasonic energy for treating tissue. The instrument further includes first and second conduits each defining a proximal end and a distal end. The second conduit is coaxially disposed about the first conduit. The distal ends of the first and second conduits extend into the lumen. The distal end of the first conduit extends further distally into the lumen than the distal end of the second conduit.

Abstract: Surgical devices and methods are described. The loading devices can include an elongate shaft extending distally from a housing and a hinge can be disposed between the elongate shaft and an articulating distal portion. The articulating distal portion can hold an end effector to be loaded onto a surgical device. The loading device can have features for stabilizing and holding the distal portion at a particular angular position relative to the elongate shaft, such as washers having protrusions that seat in corresponding recesses formed in the hinge. During articulation of the distal portion, an articulation rack can be advanced which can deform the protrusions on the washers. The washers can rotate and seat in the recesses at the next angular position and change the degree of articulation. The deformable washer and corresponding recesses can apply a biasing force that holds the articulating distal portion in a desired angled position.

Abstract: Systems, instruments, methods, and compositions are described involving removing a portion of the epidermis within a donor site on a subject, and harvesting dermal plugs within the donor site. An injectable filler is formed by mincing the dermal plugs. The injectable filler is configured for injecting into a recipient site on the subject.

Abstract: The invention provides an embolic protection device for removing emboli from a blood vessel in a patient's body. The device comprises an elongate host element, an embolic protection element having a collapsed configuration and an expanded configuration, and a flexible tether connected to a distal end of the host element and to a proximal portion of the embolic protection element. The tether allows the host element to move axially and laterally relative to the embolic protection element over a limited range of motion when the embolic protection element is in an expanded configuration. The embolic protection device has a landing zone of 4 cm or less.

Abstract: Systems, instruments or devices, and methods or procedures are described in which a scalpet array is applied to a target site with the use of a pattern. The scalpet array comprises scalpets positioned on a device. Skin pixels are incised at the target site via application of a load through the scalpet array. A recipient site is prepared by positioning the pattern at the recipient site and applying the scalpet array to generate skin defects. The incised skin pixels are applied at the skin defects of the recipient site.

Abstract: An apparatus includes a body, a shaft assembly, and an end effector. The shaft assembly includes an outer tube, a proximal inner tube member, a distal inner tube member, and an acoustic waveguide. The end effector includes an ultrasonic blade and a clamp arm. A first portion of the clamp arm is pivotably coupled with a distal end of the outer tube. A second portion of the clamp arm is pivotably coupled with a distal end of the distal inner tube member. The outer tube is configured to removably couple with the body and the distal inner tube member is configured to removably couple with the proximal inner tube member such that the outer tube, the distal inner tube member, and the clamp arm are configured to removably couple with the body and the remainder of the shaft assembly and end effector as a unit.

Abstract: An adipose-derived stem cell (ASC), regenerative cell and/or regenerative factor processing system including a tissue extraction device for extracting raw tissue, such as adipose tissue, from a patient, an ASC, regenerative cell and/or regenerative factor isolator, and an implantation device for re-introducing the isolated ASCs, regenerative cells and/or regenerative factors into the patient.

Abstract: A system to detect occlusion of an intravenous catheter may include a housing, which may include a distal end configured to couple to a proximal end of a catheter adapter and an inner lumen forming a fluid pathway. The system may also include one or more transmitters, which may be disposed within the housing. The transmitters may be configured to transmit first energy waves along a length of an intravenous catheter at a first frequency, and a portion of the first energy waves that are reflected back from the catheter may be detected by the system. Based on the portion of the first energy waves that are reflected back from the catheter, the transmitters may transmit second energy waves along the length of the catheter at a second frequency, which may be greater than the first frequency and configured to reduce formation of blood clots within the catheter.

Abstract: Wall thickness of a cavity is determined by inserting a catheter into contact with a wall of a cavity in a body of a subject. The distal segment of the catheter is provided with a contact force sensor and an ultrasound transducer. The transducer is actuated to acquire ultrasound reflection data from the wall of the cavity, and while the transducer is actuated, the catheter is reciprocated against the wall of the cavity and the contact force measured between the catheter and the wall of the cavity. The reflection data is correlated with the contact force. A set of the correlated reflection data having the highest correlation with the contact force is identified. The tissue thickness between the inner surface and the identified set of the reflection data is calculated according to the time-of-flight therebetween.

Abstract: Various embodiments are directed to systems and methods for providing segmented power curves to tissue. A surgical generator may receive an indication of a first impedance of tissue to be treated by a surgical end effector. The generator may determine that the first impedance is within an impedance range corresponding to a first power curve segment of the segmented power curve and provide a drive signal to the end effector according to a first power curve. The generator may further receive an indication of a second impedance of the tissue to be treated by the end effector, determine that the second impedance is within an impedance range corresponding to a second power curve segment of the segmented power curve, and provide the drive signal to the end effector according to a second power curve.

Abstract: A direct stream hydrodynamic catheter system is provided for the removal of thrombus, lesions and the like including provisions for the infusion of drugs, lysing fluids and the like into a blood vessel. Physician controlled powered direct fluid jet streams emanate from a fluid jet emanatory in the form of robust radially directed fluid jet streams to impinge upon and ablate difficult and strong thrombus and lesions within a blood vessel. Effluent aspiration is controlled by an exhaust regulator in the form of a roller pump, but effluent removal can be assistingly influenced by the fluid pressure associated with the radially directed fluid jet streams.

Abstract: An ultrasonic surgical device capable of cutting biological tissues such as bone and cartilage. The ultrasonic surgical device includes a static casing, which sheaths an ultrasonic horn, and a lubrication film, which separates the ultrasonic horn and the static casing. The static casing, which may also incorporate a plurality of fluid channels to allow passage of fluids along its length and eventual distribution of such fluids at the cutting end and biological tissue interface, inhibits the transfer of heat generated along the ultrasonic horn. The cutting end and the static casing are separated by a flexible joint, which serves to inhibit the transfer of vibrational energy, and consequently heat, from the cutting end to the static casing. As such, the static casing remains stable and can be used both to manipulate the surgical device with greater haptic control and facilitate effective penetration of larger cross-sections of biological tissue.