Abstract: The medical procedure via a natural opening according to the present invention includes: adjusting the patient's body so that a target site on the anterior wall of a hollow organ faces in the direction opposite to the direction of gravitational force; introducing a liquid inflow conduit in the vicinity of the target site, and flowing liquid into the hollow organ via the liquid inflow conduit, to form a liquid holding area and a gas retaining area inside the hollow organ; introducing an observation device into the hollow organ, and confirming the position of the target site from the position of the gas retaining area; and incising while observation the target area.

Abstract: A tool system for working on a bone plate is described. The tool system includes a first tool and a second tool, used at the same time as the first tool to shorten or bend the bone plate. Each of the two tools includes one or more introduction openings with which in turn one or more blades may be associated.

Abstract: A straightening tool is disclosed for straightening angled tissue cutting instruments including an outer member having a proximal length portion and a pre-formed bend connecting the proximal length portion with a distal length portion extending from the bend at an angle to a distal end, and a flexible inner member movably disposed in the outer member to cut anatomical tissue. The straightening tool comprises a handle and a positioning block extending from the handle coaxial with the straightening tool. The positioning block has a longitudinal bore for receiving the distal length portion therethrough to position the distal end within a cavity of the positioning block and the bend within a longitudinal slot of the positioning block with the proximal length portion extending externally through an opening of the slot.

Abstract: A system and method for treating a necrotic section of bone. At least one channel is drilled into a bone from a common point. Each channel has a distal end that terminates proximate the necrotic section of bone. A volume of bone growth inducing compound is introduced into each channel. The volume of bone growth inducing compound is biased toward the distal end of each channel with a screw. The screw provides immediate structural support while the bone growth inducing compound permeates the necrotic section of bone. Once the bone growth inducing compound has permeated the necrotic section of bone, it promotes rapid bone growth and thus healing of the necrotic section of bone.

Abstract: An improved device for performing medical procedures, preferably minimally invasive medical procedures, includes a shaft with a proximal and distal end and a bendable tip extending from the distal end of the shaft. In some preferred embodiments, a fastener applicator extends from the bendable tip. In other preferred embodiments, a malleable section is located between the bendable tip and the shaft. The bendable tip can include a plurality of articulating segments. The improved directional device can be used to repair native valves in a patient, especially heart valves.

Abstract: A catheter for insertion in a physiological lumen is provided which includes two balloons, wherein the distance between the balloons can be adjusted. The catheter can be used for the delivery of a therapeutic substance for the treatment of conditions such as restenosis.

Abstract: An intervertebral disc device is provided comprising a probe capable of being extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, the probe forming a loop when extended from the distal end of the introducer, the loop having first and second proximal ends external to the introducer which are brought together adjacent the introducer distal end to form the loop by the proximal ends being either attached to or entering the distal end of the introducer; and a proximal handle for externally causing the probe to be extended from the distal end of the introducer and externally guiding the probe within an intervertebral disc.

Abstract: An avascular neucrosis instrument includes a drill guide member, an extension member attached to an end of the drill guide member, an indexing member attached to the drill guide member, and a flexible drill member extending along the drill guide member and exiting the drill guide member at an angle adjacent the extension member. In another embodiment, the extension is removed from the end of the drill guide member and another extension member is attached to an end of the flexible drill member. As a result, the flexible drill member can be used to form a plurality of channel arrays for the distribution of blood supply to a femoral head.

Abstract: Systems and methods using an electrode able to transmit heating or ablation energy into tissue include first and second sensing elements associated with the electrode for measuring first and second temperatures. The electrode also includes a heating element in thermal conductive contact with the electrode for heating the electrode. The systems and methods sequentially activate the heating element and sense temperatures without transmitting tissue heating or ablation energy, and then transmit heating or ablation energy and sense temperatures without activating the heating element, to derive from the sensed temperatures a prediction of maximum tissue temperature.

Abstract: An improved catheter system having a rollable electrode at its tip section capable of treating a tissue of a patient. A catheter suitable for radiofrequency ablation of cardiac tissues comprises a catheter shaft having a distal section with an open groove, a distal end, a proximal end and at least one lumen extending therebetween, wherein a rollable electrode secured onto a moving wire is disposed at the tip section of the said catheter to treat the tissue. In one embodiment, the rollable electrode is moved forward and/or backward while the RF energy is delivered through the rollable electrode to the tissue, creating a true linear lesion without dragging the catheter.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus includes placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70.degree. C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: A vise to aid in bending a bone plate. The vise includes an elongate handle and a first clamp mechanism. The clamp mechanism includes a plate-receiving slot having an axis perpendicular to the long axis of the handle and rotationally fixed to the handle. The clamp mechanism also includes a moveable jaw bordering the plate-receiving slot. A jaw tightening mechanism urges the moveable jaw against a bone plate positioned in the plate-receiving slot to thereby secure the plate in the vise.

Abstract: A method of treating a sphincter provides a catheter means and an energy delivery device means coupled to the catheter means. The energy delivery device means has a tissue piercing distal end. The catheter means is introduced into an esophagus. A sphincter exterior surface is pierced with the energy delivery device means tissue piercing distal. The energy delivery device means tissue piercing distal end is advanced a sufficient distance in an interior of the sphincter to a tissue site. Energy is controllably delivered to the tissue site. Controlled cell necrosis is created in the sphincter to reduce a frequency of sphincter relaxation.

Abstract: A prosthetic system is provided for secure mounting of a prosthetic component to a bone, and particularly to a bone that may be diseased, damaged or deteriorated. The prosthetic system includes a plurality of screws that are mounted to healthy bone stock. Each screw includes a threaded portion extending from one end and a non-threaded portion extending from the opposed end. The non-threaded portion includes a discontinuous surface configuration thereon. Ends of the screws are positioned to support the prosthetic component. The bone cement is then disposed between the prosthetic component and the bone and in surrounding relationship to portions of the screws that project from the bone. The cement surrounds and attaches to the protrusions on the screws so that the screws and the cement reinforce one another in response to loads imposed thereon during use of the prosthesis.

Abstract: An introduction apparatus for approximating a longitudinal member and an implant to permit fixation therebetween. The introduction apparatus having a gripping nose for securely engaging an implant, a lateral approximation mechanism for laterally aligning an implant and an offset longitudinal member, and a reduction mechanism for reducing the vertical distance between the implant and the longitudinal member. The introduction apparatus is provide with a gripping nose actuated by axial movement of a clamping shaft in an outer sleeve. The clamping shaft further includes an axial cannula for passage of a fastener to the implant.

Abstract: A method and device facilitates the procedure of a transverse osteotomy of both ilium and a secondary osteotomy through the pelvic symphysis. A plate is utilized which has facility for attachment of eight screws into the, animal bone tissue to more securely hold the plate in place.

Abstract: The apparatus of the invention includes at least a first device (21) with a rigid elongated body (1) including two main sections angularly coupled with each other by an angular coupling region forming an angle substantially equal to the angular correction to be applied to a bone (18). First anchoring elements (5) shaped as pins are provided to be transversely attached to the proximal portion (24) of the bone (18); second anchoring elements in the form of bone screws (26) are provided to be attached to the diaphysis portion of the bone (18). The first device (21) is positioned on the bone (18) following an opening osteotomy (23). A second device (22) n the form of a four pin clip, may be positioned on an adjacent bone (19) on each side of a closure osteotomy (27) in order to complete the correction. A Hallux Valgus can thus be corrected.

Abstract: A fixation apparatus including a body portion and a plurality of leg portions extending from the body portion. The body portion is resiliently deformable between an initial orientation and an insertion orientation upon application of a force to the body portion. The leg portions are oriented at an angle relative to the opposite leg portion when the body portion is in the initial orientation and the leg portions are substantially parallel when the body portion is moved to the insertion orientation for insertion of the leg portions into tissue. The leg portions at least partially return to the initial orientation when the force applied to the body portion is released such that the leg portions anchor the fixation apparatus to the tissue.

Abstract: A compact torsional tightener system for anchoring tools or implants in bone or dentine or elements in implants anchored in bone or dentine sufficiently compact to be inserted into a patient's mouth includes a transformerless electric motor with a small rotating mass operating at a speed of about 10,000 to about 15,000 revolutions per minute and powered by an energy supply circuit. A gear part converts the speed of the motor to a slower speed.

Abstract: A bone fixation apparatus for anchoring a surgical member to bone for the fixation of bone or soft tissue to bone. The bone fixation apparatus includes a post device having a leg portion slidably insertable into a hole formed in bone. The leg portion is of sufficient length relative to the interior diameter of the hole to resist removal of the leg portion from the hole when forces substantially parallel to the outer surface of the bone are applied to the post device to anchor the surgical member to bone. In one aspect of the invention, the surgical member is a plate section of an elongated sheet of surgical plate material which may be divided into a plurality of plate sections each having an arbitrary shape.

Abstract: An atherectomy catheter including an expandable cutter head having spaced apart blades radially extending from a cutter sleeve at a leading end of the cutter head. A torque tube is attached to and surrounds the blades at an expanding end of the cutter head opposite the leading end. An expander cable is attached to a bushing within the cutter head adjacent to the cutter sleeve and blades with the expander tube axially displaceable through the torque tube. A guide wire slidably extends through the bushing and expander tube. A guiding catheter substantially encloses the torque tube with the torque tube rotatable and axially displaceable within the guiding catheter, to rotate the cutter head as it engages a blockage in a blood vessel, An inflatable low pressure balloon around the torque tube applies a bio-active agent directly to tissues of the blood vessel cut during atherectomy. A stent with bio-active agent promotes healing of the vessel.

Abstract: A pair of surgical in situ rod benders having keyhole notches to prevent slipping off the rod while in use. The in situ benders also have a 20.degree. offset angle to allow a criss-cross pushing tension during bending. A flat tapered handle helps the surgeon counter rotational torques during bending.

Abstract: A marrow nail engagable with a plurality of screws for securing the nail in a bone of a patient. The marrow nail includes a plurality of recesses defined proximate one end of an elongated rod. Each of the plural recesses is formed as a notch and is operably engagable with a respective one of the plural screws. A holding arrangement is disposed at the other end of the marrow nail rod and is implemented as a threaded assembly for facilitating movement of the marrow nail in the patient.

Abstract: A pair of pivotally attached handles are normally displaced away from each other via a spring biasing arrangement, and are displaced toward each other as by squeezing the handles against the spring bias. A wire or pin is introduced into a fixed fracture or osteotomy and an end thereof is received in an angled slot at an operating portion of one of the handles so that when the handles are squeezed against the spring bias the operating portions of both of the handles cooperate to bend the wire or pin to prevent migration or skin puncture, as the case may be.

Abstract: A plurality of instruments or members are provided to plastically deform spine plates or rods to a configuration which corresponds to a desired configuration for connection with a spinal column. A pair of flat benders have slots which are engageable with a spine plate to bend and/or twist the spine plate. A pair of tube benders are engageable with a rod to bend the rod. One of the flat benders may be used with one of the tube benders to form a bend in the rod. In addition, the two flat benders may be used together to bend the rod. These instruments make possible two dimensional bending of spine plates and three dimensional bending of spine rods.