Abstract: A catheter includes multiple shock wave generators in a balloon between proximal and distal ends of the catheter and electrically controlled by software of a controller to produce shock waves at different discharge point locations for intracorporeal treatment of a blood vessel.

Abstract: A tissue removal tool for use with an endoscope. The tool includes a loop formed by a piece of wire. The loop is movable between an open position and a closed position. The shape of the loop is defined in the open position by a proximal portion and a distal portion. The piece of wire may have a cross-sectional height in the proximal portion unequal to a cross-sectional height in the distal portion.

Abstract: The invention relates to a sealing device for repair of cardiac and vascular defects or tissue opening such as a patent foramen ovale (PFO) or shunt in the heart, the vascular system, etc. and particularly provides an occluder device and trans-catheter occluder delivery system. The sealing device would have improved conformity to heart anatomy and be easily deployed, repositioned, and retrieved at the opening site.

Abstract: An adjustable loop stripper for stretching an arterial wall outwardly as plaque is excavated inwardly.

Abstract: There is a main tube with a flexible pull wire guide with a pull wire slidably housed within. A plunger is slidably housed within the main tube, and moves from an open orientation to a close orientation. A specimen snare wire loop is fixedly attached to the end of the pull wire. A basket wire has a loop with an attached specimen basket. The specimen snare loop and the basket wire loop are aligned. The snare wire cuts the specimen, and the basket wire loop and net captures the specimen.

Abstract: A mixed reality endoscopic surgical procedure method, including the steps of selecting a holographic first image of a body part to be surgically operated on in three-dimensional form and displaying the holographic first image of the body part. The method can further include positioning an endoscope relative to the body part, wherein the endoscope further includes a guidewire, displaying a second holographic image or video of the endoscope or guidewire relative to the body part, and using the first holographic first image as a visual guide for engaging the body part via the guidewire.

Abstract: Methods for suspension fixation most applicable for a Latarjet of bone block procedure are performed using an open surgery with an anterior approach. The method passes endobuttons and sutures through the glenoid from posterior without the need of a posterior drill guide and disposable drill/sleeve. As an alternative embodiment, a passing pin with a slot at the advancing end may be used to further reduce surgical steps. The passing pin may be advanced and exit the muscle, and the suture loop may be directly attached to the pin rather than a secondary shuttle suture and then retrieved anteriorly.

Abstract: The devices and methods described herein relate to improved structures for removing obstructions from body lumens. Such devices have applicability in through-out the body, including clearing of blockages within the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: Catheter-based delivery systems for delivery and retrieval of a leadless pacemaker include features to facilitate improved manipulation of the catheter and improved capture and docking functionality of leadless pacemakers. Such functionality includes mechanisms directed to deflecting and locking a deflectable catheter, maintaining tension on a retrieval feature, protection from anti-rotation, and improved docking cap and drive gear assemblies.

Abstract: A medical device may include a handle, a sheath fixed relative to the handle, a longitudinal actuator movable relative to the handle, an end effector, a member extending proximally from the end effector through the sheath, with a portion of the member being fixed relative to the longitudinal actuator, and a rotation actuator. Movement of the rotation actuator may cause rotation of the member relative to the sheath, and movement of the longitudinal actuator may cause longitudinal movement of the member relative to the rotation actuator.

Abstract: In one example, a medical device may be adapted for use with a delivery device, and the medical device may include a handle including at least one actuator; a body adapted to releasably mount to a distal portion of the delivery device, the body supporting a pair of jaws rotatably coupled to the body; and a control wire coupled to the pair of jaws and the actuator. The actuator may be configured to open and close the pair of jaws.

Abstract: An occluder, an occluding system, and a conveying device are provided. The occluder includes an occluding frame. The occluding frame includes a first occluding unit, a middle portion occluding unit, a second occluding unit, and waist portions. Both ends of the middle portion occluding unit are connected to the first occluding unit and the second occluding unit, respectively, by the waist portions. A fixing member is sleeved on each waist portion. A channel is formed at a middle portion of each fixing member. The occluding frame has an inner cavity. A first opening is formed on the first occluding unit. A second opening is formed on the second occluding unit. The first opening, the channel, the inner cavity, and the second opening are communicated to form a path. A locking member can be omitted in the occluder.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: An endoscopic snare net comprises a net engaging a loop, such as by weaving the loop through a mesh of the net, and a tube having a lumen through which the net and loop may be extended and withdrawn by a control wire. The loop has one or more corners or a collared, free-floating slip tether or both thereof, which prevent the net from sliding free of the loop as the loop is retracted into the lumen of the tube, even if the loop is over-extended beyond the end of the tube.

Abstract: A method of marking lesions is disclosed herein. The disclosed method may assist surgeons localize small nodules by marking the nodules with a fiducial coil soaked with a fluorescent dye. In some preferred embodiments, the fiducial coil is placed at the time of biopsy using a robotic surgery system. In alternate embodiments, non-robotic peripheral navigation platforms may also be used effectively as an adjunct to surgical resection. The dye marks the location of a nodule, making it visible and palpable at the time of surgery. A surgeon may then target cancerous tissue with greater precision. The disclosed method allows a fiducial coil to be placed several days prior to surgery.

Abstract: A medical assembly and method of use includes a catheter, a medical instrument and a navigation system. A localization element is attached to a handle of the catheter. A localization element is attached to a handle of the medical instrument. The localization elements are detectable by the navigation system. The medical instrument includes a needle, when the needle is positioned entirely within a working channel of the catheter, a tip of the needle is in an unextended position and the location elements are in a zeroed out position. When the needle tip extends out of the working channel to an extended position, the location elements are in an extension position. In the extension position the distance between the location elements is less than in the zeroed out position. The difference between the zeroed out position and the extension position is displayed on a display as a needle stroke value.

Abstract: An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has an outer body and an inner body present within a lumen of the outer body. The outer body may be malleable and have a pre-set deflection or may be flexible and achieve deflection when being inserted into the epidural space. Once in the epidural space, the inner body is extended distally from the lumen of the outer body such that a distal tip on the inner body extends further into the epidural space to provide clearing to the target site without requiring further ingress of the outer body. The inner body is retracted and the clearing tool is removed. The medical lead is then inserted through the window and cleared epidural space until reaching the target site.

Abstract: A looped wire is provided for placing an endograft into a blood vessel. The looped wire comprising a flexible guidewire with one or more loops distributed along its length. The one or more loops have an inner diameter that is larger than the thickness of a suture or wire for threading the suture or wire through. The one or more loops is adapted for sliding along the suture or wire. Endograft system comprising the looped wire, and methods of using the looped wire are also provided.

Abstract: An ergonomic medical device handle which allows for multiple type grip styles and reduces operator fatigue by balancing the weight of the device about a fulcrum point. More particularly a laparoscopic suction irrigation device having its tubing centrally located to allow the handle to rest comfortably and balanced on the hand in any of the commonly used grips. This dramatically reduces the fatigue associated with holding devices for long periods of time.

Abstract: An apparatus for retracting a sheath from over an expandable medical device includes a shell, configured to couple to a longitudinal element, a carriage disposed within the shell and configured to couple to the sheath, and a lever protruding from the shell. The lever is configured to retract the sheath while a distal end of the longitudinal element contacts the expandable medical device, by rotating proximally so as to move the carriage proximally by a first distance, and, subsequently to rotating proximally, sliding proximally so as to move the carriage proximally by a second distance. Other embodiments are also described.

Abstract: A tissue fixation system including a delivery tube and an elongated fastener with a loop at a proximal end and a distal end. A proximal end of an elongated curved needle is attached to the delivery tube. A distal end of the needle is configured to penetrate tissue. The needle includes an open channel sized to receive the elongated fastener with the loop located near the proximal end of the elongated curved needle and the distal end of the elongated fastener located near the distal end of the elongated curved needle. A capture needle is slidably positioned in the delivery tube to slide through the loop in the proximal end of the elongated fastener. The capture needle is configured to grasp the distal end of the elongated fastener and pull the distal end of the elongated fastener through the loop to cinch the elongated fastener.

Abstract: A method of using a suction device to remove an object from a subject's body includes extending a suction device into the body through a lumen of a medical device and expanding the suction head from a contracted configuration to an expanded configuration within the body. The suction head may be provided at a distal end of an elongate conduit. The method may also include applying suction to move the object into the expanded suction head, and removing the suction device with the object from the body.

Abstract: Polypectomy devices and methods for making and using polypectomy devices are disclosed. An example polypectomy device may include an elongate sheath having a proximal end region and a distal end region. A shaft may be slidably disposed within the sheath. A handle may be coupled to the proximal end region of the sheath. The handle may be designed to axially shift the shaft relative to the sheath. A snare may be coupled to the shaft. The snare may include a first region, a traction region, and a distal tip region. The first region may have a non-circular cross-sectional shape. The traction region may include a plurality of traction members. At a position between two adjacent traction members the snare may have a reduced cross-sectional area relative to the first region. The distal tip region may have a circular cross-sectional shape.

Abstract: A medical implant delivery system is described. The system can be used to deliver a variety of implants including stents and/or stent grafts. The delivery system retains the implant during delivery and detaches the implant at a target location.

Abstract: Disclosed is a system for vascular access, where the system allows for transitions between retrograde and antegrade access without generation of multiple access sites and without inducing extensive vascular damage. In embodiments, the system can include a vascular access portion including a body with a first lumen for preferentially providing access in a retrograde direction into a vessel, and a second lumen for preferentially providing access in an antegrade direction into the vessel. The body can be transitioned (e.g., by way of expansion, contraction, or other deformation mode) between a retrograde delivery mode and an antegrade delivery mode.

Abstract: A tissue removal tool for use with an endoscope. The tool includes a loop formed by a piece of wire. The loop is movable between an open position and a closed position. The shape of the loop is defined in the open position by a proximal portion and a distal portion. The piece of wire may have a cross-sectional height in the proximal portion unequal to a cross-sectional height in the distal portion.

Abstract: An endoscopic forceps includes an elongate shaft defining an instrument axis. An end effector includes first and second jaw members each supporting an opposed sealing surface for clamping tissue. At least one of the jaw members is movable relative to the instrument axis such that the jaw members are movable between a first spaced-apart configuration and a second closed configuration for grasping tissue. A cutting instrument includes a reciprocating blade translatable relative to the sealing surfaces to sever tissue clamped between the jaw members. The reciprocating blade contacts an undersurface of at least one of the jaw members when the jaw members are in the second configuration to define a gap distance between the sealing surfaces. A handle adjacent the proximal end of the elongate shaft is operable to induce motion in the jaw members, and an actuator is operable to selectively translate the reciprocating blade.

Abstract: The present disclosure relates to an explantation assembly for retrieving an intracorporeal capsule implanted in a tissue of a patient comprising a first tube and a second tube. The first tube comprises a snare and a tissue. The second tube is configured to interact with the snare of the first tube and configured to be attached to the tissue of the patient.

Abstract: The endoscopic device includes a main member having a front slot and a shaft member having a spiral strip selectively running through the slot. The spiral strip is connected to a rotational element whose front end is provided with an optical element. A camera support element is extended from the main member and a camera element is supported by the camera support element. By running the spiral strip through the slot to turn the rotational element and the optical element, a viewing direction of the camera element is altered by the optical element.

Abstract: A containing element is used to capture material in a blood vessel for removal. The containing element is positioned within a constraining catheter while it is advanced through the blood vessel. A filament is coupled to the containing element which assists in opening and/or closing the containing element.

Abstract: A device and a method for increasing or restoring a flow in a body lumen are provided. The device and the method may treat conditions related to a stroke, such as an ischemic stroke, by removing an occlusion from a blood vessel and/or reopen a blood vessel. The device may comprise a tubing compartment, a central wire, and an engaging compartment. The engaging compartment may comprise a distal engaging element and a proximal engaging element. A clot or occlusion present in the body lumen such as an artery may be engaged in and/or between the distal and proximal engaging elements. Further, the positions of one or both of the engaging elements and the distance therebetween can be adjusted to ensure the engagement of the clot or occlusion.

Abstract: An apparatus including a basket device including a basket section; and a sheath on the basket device. The basket device and the sheath are configured to longitudinally slide relative to each other. The basket section includes at least two groups of loop petals including a first group having at least two first loop petals and a second group having at least two second loop petals, where the first loop petals have a different size than the second loop petals.

Abstract: An endoscopic snare net comprises a net engaging a loop, such as by weaving the loop through a mesh of the net, and a tube having a lumen through which the net and loop may be extended and withdrawn by a control wire. The loop has one or more corners or a collared, free-floating slip tether or both thereof, which prevent the net from sliding free of the loop as the loop is retracted into the lumen of the tube, even if the loop is over-extended beyond the end of the tube.

Abstract: Aspects of a device are described. One aspect is a device comprising: a housing having a first portion engageable with a scope, and a second portion engageable with a handle of a retrieval device; a platform that is movable relative to the housing, and engageable with a slider of the retrieval device; and a link assembly that is coupled the housing and the platform, and operable to move the platform and slider relative to the housing and handle. Aspects of related devices and systems also are described.

Abstract: Tissue ligation devices and methods are provides to mechanically strangulate abnormal or undesirable tissue. Tissue ligation devices include a catheter having an outer diameter smaller than the inner diameter of a standard endoscope channel such that the catheter can be inserted into the endoscope. Tissue ligation devices also include a ligation system with an expandable hood disposed located at the distal end of the catheter. A suture extends through a lumen of the catheter and has a distal loop portion exposed outside of the expandable hood.

Abstract: A medical device may include a handle, a sheath fixed relative to the handle, a longitudinal actuator movable relative to the handle, an end effector, a member extending proximally from the end effector through the sheath, with a portion of the member being fixed relative to the longitudinal actuator, and a rotation actuator. Movement of the rotation actuator may cause rotation of the member relative to the sheath, and movement of the longitudinal actuator may cause longitudinal movement of the member relative to the rotation actuator.

Abstract: An endoscope device is provided, which includes: an insertion part inserted into an examination subject; an outer coat tube disposed at an outer circumferential portion of the insertion part; a fixing member at least a part of which is inserted into the outer coat tube, and the fixing member being in contact with an inner circumferential surface of the outer coat tube; a tight binding thread wound around the outer coat tube, the tight binding thread being made flat in a state in which at least a void is pressed to be flattened, and the tight binding thread being wound such that a longitudinal surface in a flat cross section of the tight binding thread is in contact with an outer circumferential surface of the outer coat tube; and a resin layer formed on the outer coat tube to cover the tight binding thread.

Abstract: The endoscopy tool and methods of use disclosed herein are used to move gastrointestinal tissue. The endoscopy tool includes an auxiliary gastrointestinal device, or a catheter, having a proximal region and a distal region. The endoscopy tool includes a non-conductive, polymeric loop coupled to and extending distally from the distal end of the gastrointestinal device. The surfaces of the loop are smooth such that the loop can move intestinal tissue without causing lacerations.

Abstract: There is provided an endoscopic snare including: a flexible sheath 1; a cable 2 configured to slide in the sheath; a snare loop 3 connected to the cable 2, and projecting from or retracting into the sheath 1; a distal end tip 4 disposed in a distal end part of the sheath and retaining the snare loop 3; and a hand operating part for operating the snare loop 3 via the cable 2. One end of the snare loop 3 is attached to the distal end tip and the other end of the snare loop 3 is attached to a distal end of the cable. The snare loop 3 is expanded into a ring shape without a protruding portion when it is projected from the sheath 1, and is formed into an asymmetric shape where expansion is deviated to either side about an axis of the sheath.

Abstract: The devices and methods described herein relate to improved structures for removing obstructions from body lumens. Such devices have applicability in through-out the body, including clearing of blockages within the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: An apparatus, device and method are provided for executing a clot or plaque removal procedure. In one embodiment, a clot removal device may include a clot holding element for penetrating a target clot and stabilizing the clot in its position; a controllable distal filter that can be extended to cover the target clot; a distal filter, openable downstream from the clot, designed to substantially prevent flow through of clot elements, and further designed to drag the clot out of a vessel, for retrieving by the clot removal device.

Abstract: A system for removing a thrombus. The system includes an expandable device that maintains axially fixed engagement with the thrombus. The expandable device applies a first force to the thrombus according to surrounding vessel size. The expandable device applies a second force to the thrombus according to an increased vessel size to maintain axially fixed engagement.

Abstract: An apparatus (100) includes: a expandable structure (140) formable into three dimensional shapes including a range of diameters (D) and corresponding lengths (L); a movable component (106) moveable between a range of positions (124, 126) effecting the range of diameters; and a mechanical linkage (110) disposed between the movable component and the expandable structure. The expandable structure is configured to fit inside a working channel (204) of an endoscope (202) when the expandable structure is collapsed. The mechanical linkage is configured to move the collapsed expandable structure through the working channel to a selected location (400) past a distal end (404) of the endoscope and to increase and decrease a diameter of the expandable structure in response to changes in the position of the movable component when the expandable structure is at the selected location.

Abstract: A removable dual endovascular filter that may be introduced into arteries of the heart during surgery to allow sufficient blood flow to a cerebral vascular system while minimizing or preventing embolic material from traveling throughout a body circulatory system. The removable dual endovascular filter reduces the risk of stroke while minimizing obstruction of the patient's aorta.

Abstract: A catheter according to an embodiment of the present disclosure includes a mesh member, a first hollow shaft, a front end tip, a guiding film, and a core wire. The mesh member has a tubular shape and is radially expandable and contractable. The guiding film is formed with a stretchable material and is disposed on the mesh member, the guiding film having a front end located between a base end of the front end tip and a front end of the first hollow shaft. A thickness of a base end of the guiding film is larger than a thickness of the front end of the guiding film.

Abstract: An endoscopic cutting device for cutting free a probe, provided with a retaining plate, which, within the scope of a percutaneous endoscopic gastrostomy, is arranged in a stomach wall and is overgrown by the gastric mucosa, wherein, for the adjustment of the cutting element provided at a distal end of a tube via a pulling cord, an actuation force of an actuation element can be transmitted to same. In addition, the cutting device includes a cutting wire which is electrically heatable and connected to the pulling cord, and which runs outside the tube via a distal section to form a first diathermy blade. In addition, the distal end of the tube is slanted at an angle to the transverse plane thereof to form a tip, wherein the tip is facing the first diathermy blade. Furthermore, the cutting wire is directed externally around the tip to form a second diathermy blade.

Abstract: Devices used to repair ruptured tendons are described, particularly a tendon grasping device and devices for the application thereof and to the uses if these devices; the tendon grasping device is made of a suitable for surgery bio-compatible material, a series of curved elements connected sequentially to form a hollow deformable structure; in use each curved element surrounds the tendon and the structure deforms between a radially extended condition and a radially retracted condition, in which each curved element firmly surrounds the tendon by applying pressure around the tendon without penetrating it.

Abstract: A medical device includes a handle with a proximal arm and a distal arm. The proximal arm and the distal arm are pivotable via a joint. The medical device also includes a tube coupled to the distal arm and a drive wire. A distal portion of the drive wire includes an expandable end effector. A portion of the drive wire is positioned within the tube, and a different portion of the drive wire extends proximally of the distal arm and is coupled to the proximal arm.

Abstract: A tissue specimen retrieval device includes a first shaft and a second shaft telescopically movable relative to the first shaft. The second shaft supports an end effector assembly at a distal end thereof and is movable relative to the first shaft between a retracted position, wherein the end effector assembly is disposed within the first shaft, and a deployed position, wherein the end effector assembly extends from the first shaft in an expanded configuration. The end effector assembly includes a bag brim having a wire support with first and second ends that operably engage the distal end of the second shaft. The bag brim is transitionable from a first collapsed configuration within the first shaft to an expanded configuration upon deployment therefrom. The wire support includes torsion springs disposed between the first and second ends that cooperate to facilitate expansion of the bag brim upon deployment from the first shaft.

Abstract: Systems and methods for delivering and retrieving a leadless pacemaker are described. A leadless pacemaker retrieval system includes a catheter system having a snare assembly to capture the leadless pacemaker. The catheter system includes sheaths extending distally from a shaft, and the snare assembly includes several snare legs, such as segments of snare loops, that extend from one sheath to connect to another sheath. The snare loops can have bights that connect to opposing sheaths to form a docking space between the legs of the snare loops and radially between the sheaths. The snare assembly is movable between an engaged position and a disengaged position by translating the snare legs within lumens of the corresponding sheaths. In the engaged position, the snare assembly tightens around the leadless pacemaker to allow the leadless pacemaker to be retrieved. Other embodiments are also described and claimed.