Abstract: A continuum arm robot comprising: a tool, a tip section comprising a number of sections a manipulatable robotic section having multiple degrees of freedom, a stiffening section comprising a passive core with an inflatable section surrounding the passive core and a valve for allowing a fluid into the inflatable outer; and a passive section comprising a length of flexible conduit, wherein the core of the passive section and the stiffening section contain the cables for manipulating the tip section and the fluid conduit for supplying the fluid to the inflatable outer.

Abstract: An implantable restraint is provided that includes an opening-configured to receive a tissue anchor; a pair of protrusions between the opening and a distal edge, providing an anchor resistance to a longitudinal force; where the pair of protrusions are further configured to separate by a distance approximately equal to the tissue anchor when the longitudinal force exceeds a first predetermined threshold, such that the pair of protrusions moves past the tissue anchor. By providing one or more openings extending through the substrate, the growth of tissue which naturally occurs after implantation is utilized to assist in securing the implantable restraint at the implantation site. By providing the pair of protrusions configured to provide resistance, a high degree of control of the restraining force and the explantation force is provided.

Abstract: A medical instrument includes an instrument shaft with exit holes near a distal end of the shaft, a tool coupled to the distal end of the shaft, and a backend. The backend may include a mechanism that manipulates a drive element that extends through the shaft and couples to the tool, a fluid inlet, and a fluid channel assembly providing fluid communication between the fluid inlet and the proximal end of the shaft. Cleaning fluid is directed into the fluid inlet, through the fluid channel assembly, and into the shaft. A chassis or other structural piece of the backend may form part of the fluid channel assembly.

Abstract: A neuromonitoring surgical device for bone and tissue removal is a device that is designed for spinal decompression procedures to enable the removal of bone or tissue while enabling the user to monitor the tissue being grasped with the device. The device includes a bone-and-tissue remover, a first tissue probe, a first light indicator, a cable connector, and a monitoring device. The bone-and-tissue remover is designed to enable the minimal invasive removal of bone and/or tissue during the spinal decompression procedure. The first tissue probe enables the automatic detection of neural tissue grasped by the bone-and-tissue remover. The first light indicator directly alerts the user when neural tissue has been grasped by the bone-and-tissue remover. The cable connector enables the electrical and electronic connection of the bone-and-tissue remover to the monitoring device. The monitoring device allows the monitoring of the operation of the first tissue probe during the surgical procedure.

Abstract: In one embodiment according to the present invention, a stent is described having a generally cylindrical body formed from a single woven nitinol wire. The distal and proximal ends of the stent include a plurality of loops, some of which include marker members used for visualizing the position of the stent. In another embodiment, the previously described stent includes an inner flow diverting layer.

Abstract: A guidewire is slidable through a percutaneous medical device. A distal end of the percutaneous medical device is moved in a proximal direction away from an anatomical site of a body of a subject. Simultaneously, a position of a distal end of the guidewire, with respect to the anatomical site, is maintained by moving a housing toward another housing that is coupled to the medical device. Other embodiments are also described.

Abstract: Systems and methods for extending a guidewire from an insertion tool are disclosed. A guidewire assembly includes a slider configured to engage a guidewire carrier. The guidewire carrier defines a lumen configured to receive a guidewire therein. The guidewire carrier is biased to a non-linear, coiled resting state and can elastically transition to a linear extended state. As the guidewire assembly and slider are urged distally, the slider transitions the guidewire carrier from the non-linear state to the linear extended state. A distance travelled by the slider is less than a distance travelled by a tip of the guidewire as the guidewire carrier transitions from the coiled state to the linear state.

Abstract: Assemblies and delivery apparatus for delivering a medical device into a patient's vasculature are disclosed. In some examples, an assembly includes a delivery apparatus and a radially compressible and expandable prosthetic heart valve. The delivery apparatus includes a handle, a first shaft and a second shaft extending from the handle, and a locking mechanism to prevent axial movement of the second shaft relative to first shaft. The second shaft extends coaxially through the first shaft and includes, at a distal end portion thereof, a balloon, one or more radiopaque markers, and the prosthetic valve radially compressed over the balloon. A flared end piece extending from the first shaft covers a proximal portion of the balloon during advancing of the delivery apparatus through a patient's vasculature. The first shaft is retractable relative to the second shaft to expose the balloon from the flared end piece.

Abstract: Embodiments of a deployment system may include a catheter having a distal end and a proximal end. An actuator may be disposed at the distal end of the catheter and may be operatively connected to electrical connectors extending longitudinally along the catheter from the proximal end to the actuator. The electrical connectors may be configured for transmission of signals to the actuator. One or more connections may be coupled to the actuator and to a deployable medical device disposed at the distal end of the catheter.

Abstract: A pusher assembly for a stent delivery device includes a distal end of an elongate member and a stent-engaging member having proximal and distal ends. The proximal end of the stent-engaging member is mechanically coupled to the distal end of the inner member by a connector, or the proximal end of the stent-engaging member is at least partially inside the distal end of the elongate inner member. The stent-engaging member includes a portion that radially outwardly extends towards the distal end of the stent-engaging member, or the stent-engaging member includes a portion that radially outwardly extends towards the distal end of the stent-engaging member. The stent-engaging member is configured to move a stent when distally advanced and configured to not move a stent when proximally retracted. A stent delivery device includes an elongate outer member, an elongate inner member coaxially positioned within the outer member, and the pusher assembly.

Abstract: A stent delivery system includes a core member and an expandable member coupled to the core member distal segment. A stent extends along the core member distal segment such that an inner surface of the stent is positioned over the expandable member. The stent has a primary heat-set configuration where the stent is radially expanded, and a secondary heat-set configuration where the stent is radially compressed. The expandable member is adapted to radially expand at least a portion of the stent from a radially compressed configuration toward a radially expanded configuration.

Abstract: A septal closure and port device for implantation in the atrial septum of a patient's heart includes an expandable frame with a central portion defining a lumen, and first and second opposing end portions. The frame can expand and contract between a compressed, tubular configuration for delivery through the patient's vasculature and an expanded configuration in which the first and second end portions extend radially outwardly from the opposite ends of the central portion. The device can also have a valve member supported on the frame and positioned to block at least the flow of blood from the left atrium to the right atrium through the lumen of the frame. The valve member permits a medical instrument to be inserted through the lumen and into the left atrium, for performing a subsequent medical procedure in the left side of the heart.

Abstract: Disclosed herein are steerable catheter assemblies that utilize various mechanisms to accomplish independent control of catheter flex magnitude and catheter flex direction to provide improved steerability of an attached catheter. Some embodiments include a catheter with two or more pull wires that flex the catheter and a control handle coupled to the catheter. The control handle can include a direction control coupled to the two or more pull wires such that adjustment of the direction control adjusts a direction of catheter flex by the two or more pull wires, and the control handle can include a magnitude control coupled to the two or more pull wires such that adjustment of the magnitude control adjusts the magnitude of catheter flex.

Abstract: A catheter includes a catheter body and a distal tip section that includes an elongated member that extends along a longitudinal axis. An anchor mechanism can be disposed along an outer surface of the elongated member and/or within the elongated member in a first configuration. In a second configuration, the anchor mechanism can be configured to extend radially outward with respect to the longitudinal axis to surround at least a portion of the distal tip section.

Abstract: A guide catheter extension, having a push member having a proximal end and a distal end; a tube frame coupled to the distal end of the push member, the tube frame defining a lumen having a diameter sufficient to receive an interventional vascular device therethrough; and an inflatable element coupled to the tube frame, wherein the inflatable element is expandable into the lumen.

Abstract: A method of deploying an ocular implant into Schlemm's canal of an eye. The method includes the steps of inserting a distal end of a cannula through a cornea of the eye and into an anterior chamber of the eye, the cannula having a distal opening extending from the distal end and through a side wall; placing the distal opening of the cannula into fluid communication with Schlemm's canal; advancing the ocular implant distally through the cannula with a delivery tool engaged with the ocular implant, a proximal portion of the ocular implant engaging the delivery tool proximal to a distal portion of the delivery tool; and disengaging the ocular implant and the delivery tool when the proximal portion of the ocular implant reaches the cannula distal opening. The invention also includes a system for practicing the method.

Abstract: Balloon catheters for delivery of prosthetic hear valves is provided. The balloon catheters are configured to deploy a prosthetic heart valve through inflation. The balloon catheters are further configured with one or more retention bumpers to reduce or prevent migration of the prosthetic heart valve during delivery. Balloon catheters described herein are configured with substantially incompressible retention bumpers that promote longitudinal inflation fluid flow.

Abstract: An implant can include a flexible body made of a non-bioresorbable hydrogel material. The implant can also include a radiopaque marker located within the flexible body, where the body and the radiopaque marker can be implanted in a body cavity to mark the cavity in a radiographic image of the cavity.

Abstract: In some examples, a simulator system may simulate one or more minimally invasive surgery (MIS) procedures associated with bone removal. The simulator system comprises an input device configured to detect a position of a portion of a user tool relative to an operation envelope, a simulation device defining one or more surfaces that define one or more boundaries for a movement of the user tool relative to the operation envelope during a simulated surgical procedure, and processing circuitry. The processing circuitry is configured to receive, from the input device, information indicative of the position of at least the portion of the user tool relative to the operational envelope, generate a performance metric based on the position of at least the portion of the user tool relative to the operational envelope over a period of time, and output, for display to a user, the performance metric.

Abstract: One aspect of the disclosure relates to an aspect of the disclosure relates to an adjustable implant including: a housing; a first adjustable member at least partially positioned within the housing and moveable relative to the housing; and a first actuation assembly positioned within the first adjustable member and configured to move the first adjustable member relative to the housing.

Abstract: An inflatable bone tamp for performing a minimally invasive surgical procedure includes an outer shaft defining an internal lumen, an inflatable structure coupled to the outer shaft, and an inner shaft movably disposed within the internal lumen and coupled to a distal end region of the inflatable structure. The internal lumen is sized to receive the inflatable structure, such that by moving the inner shaft relative to the outer shaft, the inflatable structure can be retracted into the internal lumen (and likewise can be extended from within the internal lumen for deployment in bone). This retraction capability can beneficially protect the inflatable structure during positioning/removal, and can also enhance recovery from radial tears of the inflatable structure.

Abstract: A urological device, that provides for the guided placement of the distal end of an indwelling catheter into a patient's bladder, includes: (a) a cylinder whose proximal end has a larger diameter than its distal end, (b) a confirmation lumen in the cylinder that is configured to allow for drainage of urine from a patient's bladder to confirm the necessary placement of the device's distal end in a patient's bladder, (c) a guide wire lumen in the cylinder that extends between its ends, (d) a guide wire, and (e) wherein the guide wire lumen is configured to first allow for the passage of the guide wire's distal end through the guide wire lumen and into the patient's bladder and then the withdrawal of the cylinder from the patient's urethra while leaving behind the guide wire's distal end in the patient's urethra for use in the insertion of an indwelling catheter.

Abstract: A device for crossing a lesion in a tissue lumen includes a crossing wire configured to pass through a lumen of a catheter, the crossing wire including a loop at a distal end of the crossing wire. The loop can have a configuration that prevents a width of the loop from exceeding a width of the tissue lumen, and the loop having a pair of lateral opposing portions configured for alignment with a wall of the tissue lumen and a leading portion interconnecting the pair of lateral opposing portions, the leading portion being configured to interrogate the lesion. The loop has a length in an axial direction of the crossing wire extending from the leading portion to proximal ends of the pair of lateral opposing portions, the length being perpendicular to the width, and the length of the loop is at least twice the width of the loop.

Abstract: A medical system includes a flexible elongate instrument and a control unit. The control unit is configured to determine a force exerted by the flexible elongate instrument on tissue of a patient, determine a driving state of the flexible elongate instrument, set a force threshold based on the driving state, and provide feedback to an operator in response to the determined force being higher than the force threshold. Different driving states are associated with different force thresholds.

Abstract: An insertion instrument includes an insertion portion, a tubular member that rotates about a longitudinal axis by a transmitted driving force, a flange portion that holds a position of the tubular member at an outer periphery of the insertion portion, a tapered portion having an outer diameter that gradually decreases toward a proximal end side, and an adhesive layer formed to smoothly connect a proximal end portion of the tapered portion and an outer periphery of the insertion portion.

Abstract: A device for clearing obstructions from a medical tube includes a housing defining an interior, an exterior, and a port providing fluid communication therebetween. The device further includes an elongated guide wire residing at least partially within the housing, and first and second rollers defining a nip therebetween that are located within the housing. A guide wire extends through the nip and is drivable for advancement and retraction thereof through the port via rotation of the rollers.

Abstract: A phototherapy method includes: introducing an ultrasound endoscope into a digestive tract; visualizing an irradiation target site in a body by the ultrasound endoscope introduced into the digestive tract; puncturing a vicinity of the irradiation target site with a distal-end section of a needle tube that is made to protrude from a distal-end section of the ultrasound endoscope introduced into the digestive tract; exposing an optical fiber from the distal-end section of the needle tube that has punctured the vicinity of the irradiation target site, by making the needle tube retreat with respect to the optical fiber accommodated inside the needle tube; and radiating light emitted from the exposed optical fiber onto the irradiation target site.

Abstract: A device suitable for guiding a trajectory of a surgical shunt or needle comprising two protractors on a curved frame configured to fit over, or attach to, the skull of a patient, wherein the two protractors are respectively oriented in a circular dimension and anterior-posterior/medio-lateral directions. A method for using the device to guide a surgical needle, probe, shunt or other instrument during surgery.

Abstract: A medical device system may include an elongate shaft having a lumen extending from a proximal end to a distal end, a proximal release wire, and a distal release wire. The proximal release wire may extend distally from a proximal end configured to remain outside the body to a distal end and may be slidably disposed within the lumen of the elongate shaft. The proximal release wire may include a distal stopper coupled to the distal end thereof. The distal release wire may extend distally from a proximal end to a distal end and may be slidably disposed within the lumen of the elongate shaft. The proximal end of the distal release wire may be slidably coupled to the distal end of the proximal release wire. The distal release wire may be configured to releasably attach a medical device to the distal end of the elongate shaft.

Abstract: Delivery devices for a stented prosthetic heart valve. The delivery device includes a spindle, at least one cord, and a covering feature associated with the spindle for selectively covering at least a portion of a stented prosthetic heart valve tethered to the spindle in a delivery state. In some embodiments, the covering feature includes a tip mounted to the spindle. The tip can include an overhang region for selectively covering a portion of the stented prosthetic heart valve. In other embodiments, the tip can include a tip body and a compressible foam bumper. In yet other embodiments, the covering feature includes an outer sheath arranged to selectively cover the stented prosthetic heart valve. The outer sheath can be elastic and stretchable for recapturing a partially expanded prosthesis, for example by including one or more windows covered by a stretchable covering layer.

Abstract: Disclosed herein are intrasacular aneurysm occlusion devices with nested proximal and distal meshes. A proximal mesh covers the aneurysm neck. A flexible distal mesh expands to fill even an irregularly-shaped aneurysm sac when it is expanded by the insertion of embolic members and/or material.

Abstract: A wire lock assembly for an access port of an elongate medical tube includes a body having an exterior surface, an interior surface, and a central opening disposed therethrough, an attachment mechanism disposed through the exterior surface of the body, the attachment mechanism having an open end and a closed end, at least one notch arranged on the body and positioned proximate to the central opening and at least one seal supported within the interior surface of the body in communication with the central opening, the seal comprising a passageway therethrough, where the interior surface of the body defines a non-linear pathway for securing one or more medical devices.

Abstract: Some embodiments are directed to a catheter system comprising an introducer having a main body, an introducer sheath projecting from the main body, and a first seal supported within the introducer and a catheter having a main body, an outer sheath projecting from the main body, a second seal supported within the catheter, and an inner core configured to be advanced axially through the main body, the second seal, and the outer sheath. The introducer can be configured to be selectively engageable with the catheter so that the catheter can be selectively and removably linked with the introducer in the axial direction. The catheter system can also be configured such that, when the introducer and the catheter are linked, the catheter can be rotatable relative to the introducer. The introducer can be configured to radially restrain an endoluminal prosthesis.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A tissue-removing element is mounted on the distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. A motor operatively engages the elongate body for driving rotation of the elongate body and tissue-removing element mounted on the elongate body. A controller is operatively connected to the motor and configured to perform a torque response routine to control a speed of the motor based on a set PWM value of the motor and a detected current applied to the motor during rotation of the elongate body and tissue-removing element.

Abstract: Devices, systems and methods are described herein to provide improved steerability for delivering a prosthesis to a body location, for example, for delivering a replacement mitral valve to a native mitral valve location. The delivery system can include a number of advantageous steering and delivery features, in particular for the transseptal delivery approach.

Abstract: A delivery system for delivering a stent to a body lumen. The delivery system includes a tubular member having an expandable stent disposed about the outer surface of the inner tubular member. The stent is maintained in a radially compressed configuration with a removable sheath. The sheath can be released using a variety of techniques.

Abstract: Delivery devices for a stented prosthetic heart valve. The delivery device includes a spindle, at least one cord, and a lateral control feature. The cord is tensioned to crimp the prosthesis to a compressed condition for delivery to a target site. Tension is lessened to allow the prosthesis to self-expand. In a tethered and expanded state in which the prosthesis has self-expanded and is connected to the spindle by the cord, the lateral control feature directs the spindle to a prescribed location relative to the prosthesis appropriate for a functional evaluation of the prosthesis. In some embodiments, the spindle is directed to a center of the prosthesis; in other embodiments, the spindle is held at a commissure of the prosthesis. The lateral control features of the present disclosure assume numerous forms.

Abstract: A replacement heart valve prosthesis is loaded onto a balloon mounted onto a balloon shaft of a catheter system. The balloon shaft is rotatably engaged with an actuator on the handle of the catheter system. Rotation of the actuator by a first amount in a first direction permits rotation of the heart valve prosthesis by a known amount during the procedure so that alignment of the commissures of the replacement valve with the commissures of the existing valve can be predictably achieved.

Abstract: Delivery devices for delivering a stented prosthesis to a target site are disclosed. Certain disclosed delivery devices include a handle assembly including an actuator, a shaft assembly interconnected to the handle assembly, and are configured to releasably retain the stented prosthesis to the delivery device with at least one elongate tension member. The delivery devices further include a torque shaft that is configured to apply and adjust the amount of tension in the each tension member. For example, the torque shaft can be configured to wind and unwind each elongate tension member around the torque shaft to correspondingly compress and expand the stented prosthesis. The torque shaft can be controlled with an actuator provided in the handle assembly, for example. In some embodiments, the actuator is further configured to axially move the torque shaft.

Abstract: An attachment apparatus to an arthroscopic tool, comprising at one axial distal end of the attachment, a pushrod end collar of tubular cross section with a hook or fastening provision at one axial distal end of said pushrod end collar to connect to a force applicator and, rigidly attached at the other axial distal end of the pushrod end collar, are at least two pairs of pushrods, wherein each pair of said pushrods are tangentially situated at opposite ends of the pushrod end collar and extends away from the pushrod end collar into channels or grooves of a pushrod guide sleeve with tubular cross section, wherein one distal end of the pushrod guide sleeve is at least a pair of cutouts for a plurality of lifting tabs placed at opposite radial distal ends along the circumference of the pushrod guide sleeve.

Abstract: This disclosure provides a transnasal odontoid retractor that can retract tissue unilaterally or bilaterally, with the retractor including one or more retractor shafts that can be configured between a closed position and an open position, and controlled using, for example, a forcep.

Abstract: A medical device may include an introducer sheath, having a distal and a proximal end and a lumen extending from the distal end to the proximal end. The introducer sheath may also include a tab formed at the distal end and extending distal to the lumen, and a frangible portion extending between the distal end and the proximal end.

Abstract: A planning device that generates control data for an ophthalmological laser therapy appliance with a laser device and a control unit, includes a first interface for supplying various data and a second interface for transferring the control data to the control unit of the ophthalmological laser therapy appliance, which is embodied to generate control data for a scanning pattern for the ophthalmological laser therapy appliance from the supplied data, by application of which scanning pattern a structure can be produced in the cornea, the limbus, and/or the sclera of a patient's eye. The planning device is embodied to generate from the supplied data, control data for the scanning pattern of this structure and/or a structure for receiving the shunt implant.

Abstract: Surgical instruments and methods are disclosed including a tissue removal tool for treatment of endometrial tissue on a background tissue of a patient. The tissue removal tool can optionally comprise a graspable portion, a shaft and an end effector. The shaft can be coupled to the graspable portion. The shaft can have a proximal portion and a distal portion and can be configured to access an anatomic location of the endometrial tissue. The end effector can be coupled to the distal portion of the shaft. The end effector can be configured to lift the endometrial tissue relative to the background tissue to a lifted position. The end effector can be configured to cut the endometrial tissue from the background tissue with the endometrial tissue in the lifted position.

Abstract: A first positional information derivation unit derives three-dimensional positional information of at least one target point of a target structure in a subject as first positional information. A second positional information derivation unit derives three-dimensional positional information of at least one feature point on an insertion structure inserted to the target structure in the subject as second positional information. A display control unit displays a positional information screen indicating a positional relationship between the target point and the feature point on a display unit.

Abstract: Embodiments disclosed herein are directed to surgical cannulas and methods relating thereto. In some embodiments, a method includes cutting one or more lines in a tubular member to form a tubular body and a hinge of a surgical cannula. In some embodiments, a surgical cannula includes a fiber brag grating (FBG) reflector mounted to a tendon for deflecting a distal tip of the surgical cannula. A controller is coupled to the FBG reflector and is configured to determine a tension in the tendon based on reflected light from the FBG reflector. In some embodiments, a surgical cannula includes a tubular body including a plurality of apertures extending therethrough.

Abstract: A nerve block introducer for introducing a catheter and also administering an initial dose of local anesthetic, the introducer having an elongated body with a distal end and a proximal end, an inlet, and at least one discharge opening for the local anesthetic near the distal end. The introducer also includes a grasping member near the distal end of the elongated body, the grasping member operably coupled to a handle near the proximal end of the elongated body such that the grasping member can be used to releasably hold a catheter by operation of the handle. The catheter may thus be positioned and left in place following removal of the introducer.

Abstract: A stent graft transport device includes a mounted state keeping wire that keeps a mounted state of a stent graft on a transport tube or a contracted state keeping wire that keeps a contracted state of the stent graft. The transport tube can be separated from the stent graft by pulling an operation end part of the mounted state keeping wire, and the stent graft can be in an expanded state by pulling an operation end part of the contracted state keeping wire. Furthermore, the operation end part of each of the wires is housed inside the transport tube. In order to draw the operation end part, a wire pulling-out string is provided, one end part of which is mounted on the mounted state keeping wire and the other end part of which is pulled out from a window arranged on a side peripheral surface of the transport tube.

Abstract: Apparatus (40) for compressing a transcatheter cardiac stent-valve (10) comprises: a first compressor stage (100) including a hollow channel (42) with a tapered interior surface configured for compressing a stent-valve in response to longitudinal advancement of the stent-valve within the channel; and a second compressor stage (102) comprising a crimper for compressing a portion of the stent-valve without longitudinal advancement.

Abstract: A method for extracting a lead from a patient comprising: providing a lead removal stylet; inserting the stylet into the lead; locking the stylet to a position inside the lead; and vibrating the stylet with tissue disrupting vibration to cause the lead to vibrate and to disconnect from binding tissue.