Abstract: A tissue treatment selection device that has at least one treatment delivery member, a delivery setting circuit that is coupled to the treatment delivery member that is adapted to be deployed into tissue to deliver therapeutic energy to a target tissue zone, and the processing circuit is operable to set treatment parameters in the delivery setting circuit that is operable to set treatment parameters in the delivery setting circuit. The processing circuit is operable to transmit a test signal through the deployed treatment delivery member and to determine deployment status. The treatment selection device has a processing circuit adapted to send a message to a display device that indicates that the deployed treatment delivery member has been determined to be compensable and contains a suggested change in the treatment parameters. Also presented herein is a method of treating a tissue of a patient using the treatment delivery device.

Abstract: A medical guidewire system including an inner member having an outer diameter and an outer member having an inner diameter, the inner diameter being larger than the outer diameter. The inner and outer members are relatively slidable to adjust a stiffness of the guidewire system. The lumen of the outer member forms a gap for fluid flow therethrough. A connector to the inner member and a fluid infusion channel communicating with the gap for injection of fluid through the gap to exit a distal portion of the outer member.

Abstract: A magnetic field device for directing a magnetic coupling source includes an electrical power source, a control module, a muzzle, and an electromagnet adjacent the muzzle and connected to the electrical power source. A magnetic sensor within the muzzle is adjacent to the electromagnet. A magnet loading chamber is adjacent to the electromagnet magnetic and opposite to the magnetic sensor. The magnet loading chamber is configured to accommodate one or more permanent magnets. A magnetic shield surrounds exterior surfaces of the electromagnet and magnet loading chamber. A user operable control device is electrically connected to the electromagnet and to the electrical power source. The control device regulates an amount of electric current from the electrical power source to the electromagnet. A magnet guidewire delivery system includes a guide wire having a magnetic element and a magnetic field device generating a magnetic field that couples with the magnetic element.

Abstract: A device and method for removing atheroma. An expandable atherectomy device comprises a rotatably motor-driven flexible hollow shaft that is slidable over a guidewire introducible through a flexible catheter tube and is coaxial with the longitudinal axis of the guidewire, an expandable cutting unit connected to a distal end of the hollow shaft, and an actuator which is operable to induce selective expansion of the cutting unit. The cutting unit, when expanded, is eccentrically rotatable about the longitudinal axis to cut and remove atheromous material from a blood vessel. In one embodiment, the method also includes the step of drilling an occlusion present in the lumen of a blood vessel by a drill unit connected to the cutting unit.

Abstract: The present disclosure is directed to an over-the-needle (OTN) catheter assembly having a structural member configured therein. The OTN catheter assembly includes a catheter coaxially mounted onto a needle. In one embodiment, the structural member includes a coil insert that is embedded into an interior wall of the catheter, thereby preventing kinking of the catheter when being inserted within a patient. In another embodiment, the structural member may be a separate and removable coil insert that is inserted into the catheter after the OTN catheter assembly has been placed in a targeted site within the patient and the needle is removed. In a further embodiment, the structural member may be a separate and removable solid insert having a blunt distal end that is inserted into the catheter after the OTN catheter assembly has been placed in a targeted site within the patient and the needle is removed.

Abstract: A tissue resecting system includes an assembly having first and second tubular members. An electrical motor drive and controller moves the second member to resect tissue received in a window of the first member. A tachometer sends motor drive rotational signals to the controller, and the controller modulates a motor voltage in response to the signals from the tachometer both to drive the second member at a predetermined speed and to calculate resistance to driving the second member at the predetermined speed.

Abstract: An eye surgical cutting tool includes a tubular outer part and an axially movable tubular inner part arranged in the outer part. The outer part has a closed distal end, and the inner part has an open distal end. Both parts have an opening in the tube. Both openings are bounded on the distal side by a distal cutting edge in the respective tube. The axial position of the distal cutting edge of the inner part as a function of the circumferential direction initially proceeds towards the proximal end, and then back to the distal end again. The tool is provided with suction means to have, during use of the cutting tool, ocular tissue extended through the opening of the outer part into the interior of the outer part and to convey severed tissue via the interior of the inner part to a proximal end of the inner part.

Abstract: An apparatus includes a shaft assembly and an end effector. The shaft assembly includes a first coupling member and a second coupling member. The first coupling member and the second coupling member are configured to flex toward each other from a first position to a second position. The first coupling member and the second coupling member define a pivot axis in the first position. The end effector includes an ultrasonic blade and a clamp arm. The clamp arm is configured to couple or decouple with the shaft assembly when the first coupling member and the second coupling member are in the second position. The clamp arm is configured to pivot toward and away the ultrasonic blade about the pivot axis when the first coupling member and the second coupling member are in the first position.

Abstract: A surgical instrument includes first and second members movable between spaced-apart and approximated positions, a deployable component, and a trigger assembly including a trigger portion and a linkage portion. The trigger portion is engaged with the first member and includes a trigger configured to move relative to the first member between an un-actuated position and an actuated position. The linkage portion is engaged with the second member and the deployable component and is movable between a first position and a second position for moving the deployable component between a retracted position and an extended position. In the spaced-apart position of the members, the trigger portion and the linkage portion are disengaged and wherein, upon movement of the members to the approximated position, the trigger portion and the linkage portion are moved into engagement to enable actuation of the trigger to effect deployment of the deployable component.

Abstract: This transcatheter device for the ablation of calcified tissue at the flaps of an aortic valve, is characterized in that it comprises a flexible body (1) acting as a catheter and having a soft and flexible end piece (2) that engages with a previously inserted wire guide (g) suitable for passing through the flaps of the valve above the part where the calcified tissue needs to be removed, said end piece (2) having at least one cutting system (3) comprising two motorized rotating cutting heads (3a) and (3b) disposed coaxially one above the other, the head (3a) located at the end of the end piece and acting first to remove the calcified tissue, has arrangements suitable for making a rough cut by grinding, while the other head (3b) has arrangements suitable for making a fine cut by grinding, said cutting system being mounted in combination with a vacuum suction means (4), said end piece (2) being provided with an adjustable guide means (5) suitable for engaging with the calcified tissue over the course of the abla

Abstract: Vitrectomy probe (1) for the removal of the vitreous humour (1a) and comprising a tube (2) adapted to be put into direct contact with the vitreous (1a), defining a main axis (2a) and including an internal passage (21) and a opening (23) enabling the vitreous (1a) to enter the internal passage (21) and comprising at least one cutting edge (23a, 23b); a suction system suitable for the creation of vacuum within the internal passage (21) sucking the vitreous (1a) into the opening (23); a drive unit adapted to move the tube (2) defining a vibrational motion (A) of the tube (2) which therefore produces pressure waves reducing the viscosity of the vitreous (1a), and a reciprocating motion (B), having a frequency lower than the frequency of the vibrational motion (A), adapted to enable the cutting edges (23a, 23b) to cut the vitreous (1a)

Abstract: A slip ring assembly is used with a surgical shaft assembly. The slip ring assembly includes a first housing portion, a first connector supported in the first housing portion, and a first conductor mounted on the first connector. The slip ring assembly also includes a second housing portion, wherein one of the first housing portion and the second housing portion is rotatable relative to the other, a second connector supported in the second housing portion, and a second conductor mounted on the second connector, wherein the second conductor is in contact with the first conductor. An interface between the first housing portion and the second housing portion, wherein the interface is configured to effect a seal between the first housing portion and the second housing portion.

Abstract: The present invention relates to a supply device for a channel (8), in particular within a hollow catheter (1), and to a method for operating a supply device of this type that supplies a channel (8) with a liquid and has two pumps (10, 19) arranged at points of the channel distanced from one another, characterized in that the parameter values of at least one operating parameter of both pumps are coordinated with one another in a controlled manner. As a result of the method, interruption-free and precisely controllable operation is to be ensured with simple structural means, in particular in the case of use of wear-free diaphragm pumps.

Abstract: A bipolar electrosurgical device is disclosed that operates in a mechanical cutting mode and a hemostasis mode. The device includes a housing and a blade assembly extending from the housing. The blade assembly forms a cutting tip and cutting window at a distal end region to provide mechanical cutting of tissue and first and second electrode assemblies to provide electrical energy to tissue. The first electrode assembly includes an outer shaft defining a first electrode surface and the second electrode assembly includes an electrode body extending along and electrically isolated from an outer shaft and defining a U-shape in cross section.

Abstract: A control module for a powered surgical tool. The module includes a shell. Internal to the shell is a circuit for controlling the power generating unit of the tool with which the module is associated. Conductive pins extend through the shell to provide electrical connections to the components within the shell. Active seals are disposed around the conductors and the inner walls of the shell that define the openings in which the pins are seated. Each active seal include an inner and outer skirt. A biasing component disposed between the skirts urges the inner skirt against the section of the conductive pin seated in the opening. The biasing component also urges the outer skirt against the adjacent opening-defining inner wall of the shell. The active seal functions as a barrier between the conductive pin and the adjacent inner wall of the shell.

Abstract: A needleless transseptal device assembly, and associated methods, for accessing the left atrium of a human heart includes a tubular body sized to navigate vasculature, and a dilator having a proximal end and a distal end. The dilator is substantially housed and axially movable within the tubular body. The assembly further includes a guidewire that is substantially housed and axially movable within the dilator. The guidewire includes a flexible proximal section and a flexible distal section, and the flexible distal section has a distal end with rotatable, septal tissue cutting elements. The distal end may be configured with a blunt shape. Further, the tubular body and the dilator may be arranged in a steerable configuration. A torquing member may also be coupled to the proximal section of the guidewire to assist in the rotational movement of the septal tissue cutting elements.

Abstract: A surgical hand piece has a connecting body having first and second passages detachably connected to first and second lumens which are used in the eye for phacoemulsification procedures and/or cleanup of the eye capsule after the procedure. The lumens receive or discharge fluid from first and second fluid sources. A work tip supporting the first and second tubes can be rotated so as to change the function of the first and second tubes from aspiration to irrigation and vice versa. As an alternative, a sleeve holding the fluid sources can be rotated so as to change the function of the first and second tubes from aspiration to irrigation and vice versa.

Abstract: According to some embodiments, a method of treating a skin surface of a subject comprises heating a skin surface, abrading native skin tissue of a subject using a microdermabrasion device, wherein using the microdermabrasion device comprises moving the microdermabrasion device relative to the skin surface while simultaneously delivering at least one treatment fluid to the skin surface being treated and cooling the abraded skin surface.

Abstract: A surgical hand piece has a source of ultrasonic energy provided to a connecting body having a first passage with one end to receive fluid from a first source and the other end at the connecting body distal end. A work tip has first and second tubes each having at least one opening at its distal end and the proximal end of one or both of the tubes connected to the connecting body distal end to receive the ultrasonic energy and to selectively receive or discharge fluid from either the first or second source as controlled by a valve. A cannula is provided which is adapted to be placed in an opening in the cornea through which the work tip extends during the removal of cataracts from the eye by phacoemulsification. The cannula may be equipped with channels that permit additional infusion of fluid into the eye during the procedure, which infusion also cools the surrounding corneal tissue to protect against heat generated by the ultrasonic vibration of the work tip.

Abstract: Disclosed is an instrument that may an interior tube and an external tube. The exterior tube may be fixed relative to an interior tube, where the interior tube may rotate or oscillate relative to the exterior tube. Further, the two tubes may be co-bent such that an angle is formed by both of the tubes.

Abstract: A surgical instrument that has a cartridge receiving assembly, a shaft assembly, and a needle driving cartridge. The cartridge receiving assembly in connected to the shaft assembly. The needle driving cartridge is capable of being inserted into the cartridge receiving assembly. The needle driving cartridge is capable of driving a needle along an orbital path in a single angular direction. The needle driving cartridge includes a body, a curved needle, a needle drive assembly, and a needle guide assembly capable of guiding a needle along the orbital path. The needle guide assembly includes a cleat. The cleat has two needle engagement features. The two needle engagement features are configured to simultaneously engage two separate regions of the outer surface of the needle at the same portion of the length of the needle.

Abstract: The disclosure relates to a reduced Larsen Effect electrode. Specifically, the disclosure relates to an electrode with an insulation-coated electrode wire coaxially surrounded over a substantial portion thereof, by predetermined assembly of alternating rigid and isolating layers.

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 phacoemsulsification needle for use with an ultrasonic handpiece in performing cataract surgery has a plurality of external grooves along its shaft. The external grooves are configured to convert longitudinal drive motion delivered by the handpiece at the base of the needle into torsional motion at the needle tip. The torsional motion at the needle tip has a magnitude greater than the magnitude of the longitudinal drive motion at the base, i.e. the longitudinal to torsional gain is greater than one. The grooves may be helical grooves, wherein the groove configuration is defined by a set of groove parameters including a helical pitch of the grooves, a width of the grooves, a depth of the grooves, an axial length of the grooves, and a total number of grooves.

Abstract: A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device including a flexible portion that is suited to access target anatomy. The flexibility of an elongate portion of the delivery device can be varied. Additionally, the delivery device can include structure that maintains the positioning of the delivery device in patient anatomy.

Abstract: One aspect of the present disclosure relates to a device for aspirating a biological tissue from a subject. The device can comprise a flexible, hollow shaft and an ultrasound assembly. The shaft can have a central portion that extends between a proximal end and a distal end thereof. The shaft can include a first lumen that extends between the proximal and distal ends. The ultrasound assembly can be connected to the distal end of the shaft. The ultrasound assembly can include a casing, at least one ultrasound transducer disposed within the casing, and a second lumen that extends through the ultrasound assembly and is in fluid communication with the first lumen. The at least one ultrasound transducer can be configured to generate acoustical waves having an intensity and frequency sufficient to disrupt, but not substantially damage, the biological tissue so that the biological tissue can be aspirated through the device.

Abstract: Described herein is a system and method for identifying elastic lamina during interventional procedures, such as atherectomy. Such identification can be used to avoid trauma to the external elastic lamina during the procedure.

Abstract: An apparatus for operating on tissue includes an elongate shaft extending distally from a body and an end effector at a distal end of the elongate shaft. The end effector includes a first jaw that is selectively pivotable toward and away from a second jaw to capture tissue and a firing beam. The firing beam is configured to advance relative to the first and second jaws to sever captured tissue and retract relative to the first and second jaws after the captured tissue has been severed. The apparatus further includes a debris removal element in communication with the firing beam. The debris removal element is configured to engage at least a portion of the firing beam at least during retraction of the firing beam relative to the first and second jaws to thereby remove at least some debris from the firing beam.

Abstract: In one general aspect, various embodiments are directed to systems and methods for controlling a surgical instrument. The surgical instrument may comprise an ultrasonic transducer, a blade extending distally from the ultrasonic transducer along a longitudinal axis, and a motor coupled to the ultrasonic transducer. The motor, when activated, may rotate the ultrasonic transducer and the blade about the longitudinal axis. A control system may receive an indication to operate the surgical instrument according to an ultrasonic-only mode. The control system may instruct the motor to rotate the blade to a park position, and activate the ultrasonic transducer to longitudinally vibrate the blade.

Abstract: An ultrasound system has a catheter including an elongate flexible catheter body having at least one lumen extending longitudinally therethrough. The catheter further includes an ultrasound transmission member extending longitudinally through the lumen of the catheter body, the ultrasound transmission member having a proximal end connectable to a separate ultrasound generating device and a distal end coupled to the distal end of the catheter body. The distal end of the catheter body is deflectable. The ultrasound system also includes a sonic connector that connects the ultrasound transmission member to an ultrasound transducer. The ultrasound system also provides a method for reverse irrigation and removal of particles.

Abstract: Antibiotics are administered in a surgical site subcutaneously via a small or stab incision in the surgical field. Transcutaneous ultrasonic vibrations are applied across the surgical field, which is then opened in the usual manner, to thereby provide a surgical field which contains a vastly higher and more effective level of antibiotic. At the same time the underlying tissue is hydrated.

Abstract: Embodiments of the present invention provide improved methods and apparatus of treating the prostate. In many embodiments, at least a portion of the prostate is enucleated with a water jet, in order to decrease the invasiveness of the surgery. The access to the prostate can be provided with one or more of open surgical access, percutaneous access, or urethral access. The prostate can be enucleated such that an inner portion of the prostate comprising adenomatous tissue of the prostate is separated from a portion an outer the prostate comprising the capsule. In many embodiments, the patient is treated with energy of the water jet configured to separate the capsule from the inner tissue of the prostate and to inhibit cutting of blood vessels.

Abstract: A tubular structure comprising multiple overlapping layers surrounding a lumen has flexibility and structural integrity by allowing portions of the layers to slip relative to each other. One embodiment includes a support layer having a wired coil, braid or weave support element underlies at least one overlying layer. The support layer is fixed to the overlying layer at a bonding point and the remaining portion of the support layer is not fixed to the overlying layer, i.e. “free portion”. The support layer is permitted to slip at the free portion of the support layer, relative to the overlying layer. Further flexibility may be provided by a coil element of the support layer having substantial gaps between the loops of the coil to impart high flexibility of the tubular structure.

Abstract: A catheter system for accessing the central venous system through an occlusion in the neck region.

Abstract: A tool bit (100) of an ultrasonic osteotome includes: an arbor (2); and an end portion (1) of the tool bit connected to a front end of the arbor (2). The end portion (1) of the tool bit has a spoon-like shape and has a toothed front edge. An ultrasonic osteotome including the tool bit is also provided.

Abstract: An ultrasonic motion generator includes a non-resonant inverter, an ultrasonic transducer, and a comparator. The non-resonant inverter inverts direct current (DC) to alternating current (AC) having a first frequency. The ultrasonic transducer is electrically coupled with the non-resonant inverter and generates an ultrasonic motion based on the inverted AC. The comparator automatically detects a deviation of the first frequency from a resonant frequency of the ultrasonic transducer based on motion current passing through the ultrasonic transducer and generates an output signal based on the deviation to drive the non-resonant inverter.

Abstract: Apparatus, including a rigid gripper configured to fasten around a cylindrical object. The apparatus further includes a pair of conductors attached to the gripper so as to make contact with one another, while the gripper is fastened around the cylindrical object, at a location along a length of the conductors that varies responsively to a diameter of the cylindrical object. The apparatus also includes a sensing circuit configured to measure an impedance of a current passing through the pair of conductors and to generate an indication of the diameter responsively to the impedance.

Abstract: A method of delivery ultrasonic energy and a therapeutic compound to a treatment site and an ultrasonic catheter system are disclosed. The ultrasonic catheter system comprises a tubular body having a proximal end, a distal end and a treatment zone located between the distal end and the proximal end, a fluid delivery lumen, at least one ultrasound radiating element positioned in the treatment zone, wiring electrically coupled to the at least one ultrasound radiating element and extending through the tubular body and terminating at a connector, and a control system comprising external circuitry and an isolation pod that is configured to be electrically connected to the connector, the isolation pod being positioned between the tubular body and the external system and comprising an isolation barrier and circuitry for driving the ultrasound radiating element.

Abstract: A method for establishing the refraction of an eye (9) by means of a refractometer (3) is provided, in which the current visual axis (S) of the eye (9) is established before establishing the refraction, the refractometer (3) is aligned with respect to the visual axis (S) of the eye (9) and the refraction is established after the alignment. The visual axis (S) of the eye (9) is established on the basis of the position of a Purkinje image of at least one light source (41, 50) used to illuminate the eye and a relationship between the position of the Purkinje image and the visual axis (S).

Abstract: A surgical stapler. The surgical stapler includes a drive system, an electric motor, a battery and a control system. The electric motor is mechanically coupled to the drive system. The battery is electrically couplable to the electric motor. The control system is electrically connected to the electric motor and includes an H-bridge circuit and a current mirror circuit. The H-bridge circuit includes a plurality of switching devices. The current mirror circuit is electrically connected to the H-bridge circuit. The control system is configured to control a force applied to the drive system based on a current measured at a node of the current mirror circuit. The node is electrically connected in parallel with the H-bridge circuit.

Abstract: A thrombectomy catheter system is disclosed which includes a catheter having an exhaust lumen, an infusion lumen and a high pressure tube. The high pressure tube includes a nozzle orifice for forming a high pressure jet of fluid for cutting occlusive material from within a body lumen. The nozzle orifice is positioned to direct the high pressure jet of fluid into the distal end of the exhaust lumen which creates a suctioning effect. The infusion lumen replaces fluid that is removed from the body lumen through the exhaust lumen by a suctioning effect created by the fluid jet.

Abstract: A method delivers an implantable device through the urethra and into the bladder. A deployment instrument is inserted into the urethra, the implantable device is inserted into the deployment instrument, and a stream of fluid is injected into the deployment instrument. The stream of fluid drives the implantable device from the deployment instrument into the bladder. The deployment instrument is removed from the urethra, leaving the implantable device wholly implanted in the bladder.

Abstract: Delivery systems, and methods using the same, having an ultrasound viewing window for improved imaging and a needle for ablation treatment of target tissues. In an embodiment, the target tissue is a fibroid within a female's uterus. In an embodiment, the delivery system includes a rigid shaft having a proximal end, a distal end, and an axial passage extending through the rigid shaft. In an embodiment, the axial passage is configured for removably receiving the ultrasound imaging insert having an ultrasound array disposed a distal portion.

Abstract: The methods and devices disclosed herein are effective in the promoting the reattachment of delaminated cartilage to bone. The methods (and related devices) are effective in the removal of the acellular layer of the delaminated cartilage or effective in the indentation of the acellular layer of the delaminated cartilage thereby exposing the underlying chondrocyte cells and thereby allowing the promotion of the reattachment of the delaminated cartilage.

Abstract: An electrosurgical probe for ablating tissue includes an elongated shaft having an axis and a distal end. An electrically insulating housing at the distal end of the shaft has a window, and an interior channel in the shaft extends through the housing to the window. The window faces laterally relative to the axis, and a moveable member with a blade-like electrode edge is disposed within the window. A motor drives the energized electrode edge axially in the window to ablate tissue.

Abstract: In a surgical treatment instrument, a probe extending in a longitudinal axial direction is inserted through a sheath, and each of sheath components, in the sheath, is divided from a neighboring sheath component at a dividing plane along the longitudinal axial direction. A flow of liquid to a proximal side in an inside of the sheath is prevented by a first seal portion. In a divided part between each of the sheath components and the neighboring sheath component, liquid-tight is kept by the second seal portion, and thereby a flow of the liquid to the proximal side is prevented.

Abstract: A system for cleaning bone that includes a base unit with a motor, a cleaning head with a cleaning element and a mill head with a mill element. Both the cleaning head and the mill head are designed to be coupled to the base unit. Both the cleaning element and mill element have features that facilitate their coupling to the motor. When the cleaning head is attached to the base unit, a motor in the base unit rotates the cleaning element to remove soft tissue from the bone so as to clean the bone. The mill element is placed on the base unit and the cleaned bone placed in the mill head. The actuation of the base unit motor results in the actuations of the mill element. The actuation of the mill element converts the cleaned bone into bone chips.

Abstract: An ultrasonic surgical blade includes a body having a proximal end, a distal end, and an outer surface. The distal end is movable relative to a longitudinal axis in accordance with ultrasonic vibrations applied to the proximal end. At least a portion of the outer surface of the body comprises a lubricious coating adhered thereto. The lubricious coating has a coefficient of friction that is less than the coefficient of friction of the outer surface of the body.

Abstract: An energy applicator for directing energy to tissue includes a feedline and a radiating section operably coupled to the feedline, wherein the radiating section has a length. The energy applicator also includes a length adjustment member adapted to allow for selective adjustment of the length of the radiating section. The length adjustment member includes a first pivot element and a first tensioning element coupled to the first pivot element.

Abstract: A dilation device (206) for an intra-body lumen, for example, a urethra partially occluded by an enlarged prostate in the form of a resilient curved body configured to be implanted in a cut around the lumen, and a method for dilating such a lumen by implanting a dilation device in a cut around the outside of the lumen. Also, a deployment system (300) including a delivery device for the implant, and a device for dilating the lumen before and while the cut is being made, and a method of using the implant and the deployment system. The implant may be formed of a strip or a coiled wire. The cut may be performed in part by the implant. The cut may be performed by a sharp edge, and/or by application of electrical current to the area being cut, or by a piezoelectric transducer.