Abstract: A device and related methods of use are provided for the capture and removal of various unwanted objects present within the body's anatomical lumens. In an embodiment of the present disclosure, the device includes a sheath, an elongate member, and a retrieval assembly connected to the elongate member and retractable within and extendable from a lumen of the sheath. The device includes one or more legs releasably connected to a portion of the retrieval assembly in response to movement of the elongate member relative to the sheath.

Abstract: A new reversibly gelling polyurethane (RGP) polymer composition is described, as well as novel processes for its preparation, and its medical uses for filling spaces in tissue, or bulking tissue, or for restoring organ function. The novel RGP polymer forms a gel on standing, liquefies during shear and reversibly reforms a macroscopic gel on standing after being sheared. Methods of use include delivering the improved gel to a site on the body to fill voids or to augment local tissue bulk.

Abstract: A device and related method of use is provided for the capture and removal of various unwanted objects present within the body's anatomical lumens. In an embodiment of the present disclosure, the device includes an external elongate member; an internal elongate member disposed within the external elongate member; and a retrieval assembly connected to the internal elongate member and retractable within and extendable from a lumen of the external elongate member. The retrieval assembly includes an end configured to be selectively open or substantially closed.

Abstract: A retrieval device with a shapeable snare shaft for use in minimally invasive medical procedures. The retrieval device may further comprise a delivery conduit configured to receive both a snare shaft and a guidewire in one or more lumens. The retrieval device may also include a snare loop at both ends of the snare shaft.

Abstract: Devices and methods for removing an obstruction from a blood vessel are described. The devices are deployed in a collapsed condition and are then expanded within the body. The devices are then manipulated to engage and remove the obstruction.

Abstract: Methods for restoring blood flow in occluded blood vessels are disclosed. The methods can include accessing an artery with a catheter system and locating an occluded zone within the artery caused by an embolus. The catheter system can include a microcatheter and a blood flow restoration device or an embolus removal device having a self-expandable member configured to be delivered through the microcatheter in a compressed configuration and to be deployed to an expanded configuration upon retraction of the microcatheter. The methods can include deploying the self-expandable member at the location of the occluded zone such that the self-expandable member engages and captures the embolus upon deployment of the self-expandable member and removing the embolus by withdrawing the blood flow restoration device or the embolus removal device.

Abstract: A polyp removal tool and method of use is disclosed. The tool includes a main body, an elongated hollow conduit fixed to the body, a handle, a cable assembly, a suction assembly and an irrigation system. The handle is used to actuate a snare at the end of a cable for transecting of polypoid tissue. The suction assembly is used in pre-conditioning the tissue for cutting and in polyp retention after cutting. The irrigation system is included for tissue recovery after transection. The tool may include a screen for capture of tissue within the device.

Abstract: A complex coil and a fixture for forming same configured such that loops are formed having various configurations relative to each other. The configurations provide improved thrombus formation and reduced rotation or tumbling once implanted. The complex coil is formed of a material that may deformed for purposes of placing the complex coil into a catheter and returns to a complex shape that includes said loops once deployed.

Abstract: Methods and devices are provided for controlling movement of a working end of a surgical device, and in particular for performing various surgical procedures using an instrument having an end effector that can be articulated relative to an elongate shaft of the device. In certain embodiments, the end effector can also optionally rotate relative to the elongate shaft of the device, and/or the shaft can rotate relative to a handle of the device.

Abstract: An endoscopic surgical device for retrieving objects, such as for example, severed human tissue, foreign objects or impacted food bolus, from within a subject is disclosed. The device includes a body and handle movable relative to the body, a tubular member fixed to the body, a link having a first end fixed to the handle and a second end remote from the body, and a net including a loop and a net element. The loop is expandable and collapsible by action of the handle relative to the body. The loop retains an expanded configuration when deployed to allow for the capture certain objects that were otherwise difficult to capture because of positioning, location, or object characteristics. The loop may be constructed of flat wire and form a polygon shape when deployed. Structure at the distal end of the loop may propel and retain the loop into an open position when in use in narrow organs such as the esophagus.

Abstract: A snare for snaring an article in a vessel of a vascular system or other body vessel. The snare includes a core cable having a proximal end portion and a distal end portion. The snare also includes first, second and third loops each having a proximal end portion and a distal end portion, and a mid-portion therebetween formed by spaced apart first and second sides connected together at the distal end portion of the loop. The mid-portions of each of the loops cross over mid portions of one of the other two loops, and the loops are only connected together at their proximal end portions, where they are gathered together and attached to the distal end portion of the core cable. The loops are movable between an open position and a closed position.

Abstract: An implant retrieval frame for advancement of a retrieval device to snare an implant is disclosed. The frame comprises a first arm and a second arm. The first arm has a first handle end and a first pivot end. The second arm has a second handle end and a second pivot end. The second pivot end is connected to the first pivot end to define a pivot axis about which the first and second arm pivotally move. The frame further comprises a connector to which the retrieval device is attached. The connector is configured to cooperate with the first and second arms to translate pivotal movement of one of the first and second arms to linear movement of the retrieval device relative to the pivot point.

Abstract: A rigid extractor is revealed, a rigid device for use in percutaneous procedures to remove kidney stones directly from the kidneys. The rigid extractor uses a handle fixed to an outer rigid cannula, and an inner cannula to control an extraction device that may be removable from the inner cannula. The extractor is desirably used with a fluoroscope, in which the surgeon maneuvers the extractor with the aid of a view of the operating field provided by the fluoroscope. The surgeon then maneuvers the extractor to grasp the kidney stones and remove from the patient. The extractor may also be used with a nephroscope. The device may be used with a removable extraction device such as a basket, a grasper a pair of jaws, or a pair of scissors.

Abstract: Surgical eversion apparatus for preparing a conduit for anastomosis in a human patient includes an everting member having a loop shaped portion adapted to be inserted into an end portion of a conduit harvested from a human patient and configured to fold a portion of the conduit end portion over itself when moved proximally away from the end of the conduit and along the conduit while a portion of the conduit is held fixed relative thereto. A method of everting a graft includes positioning a graft in a support device such that an end portion of the graft extends therefrom; introducing a generally looped shaped member into the end portion of the graft extending from the support device; and moving the looped shaped member over the support device to fold at least a portion of the end portion of the graft over the support device.

Abstract: A medical device removal system includes a vessel filter repositioning or removal device to remove and/or reposition a medical device, such as a vessel filter. The system includes a gripper to grip a medical device that is located within a body vessel, and a detector, linked to the gripper, to detect the proximity of the medical device to the gripper. The system may also include an output to indicate a signal from the detector.

Abstract: A medical retrieval device used to remove objects such as urinary and biliary calculi from the body comprising a handle assembly with an independent rotational means, a sheath, and an object entrapping assembly. In preferred embodiments, the handle assembly comprises a longitudinally stationary base portion and a thumb slide actuation means. The longitudinally stationary portion comprises a handle base and a rotating means. In a preferred embodiment, a portion of the thumb slide actuation means is located between the distal and proximal ends of the handle base portion during the complete actuation cycle. Actuation of the thumb slide relative to the handle base causes the object entrapping assembly to be actuated between the open and closed positions. Rotation of the rotating means relative to the handle base causes precise rotation of the object entrapping assembly.

Abstract: Disclosed herein are devices and methods for forming multidirectional cuts in tissue. The tissue cutting devices disclosed herein generally include a flexible elongate member with at least first and second wires that are at least partially constrained within or along a portion of the member. A distal portion of the wires is anchored on or within a portion of the elongate member. When tension is applied to one of the wires, such as by an actuator at a proximal end of the device, the elongate member bows while an unconstrained portion of the wire becomes exposed relative to the adjacent portion of the elongate member, assuming a tissue-cutting configuration.

Abstract: Embodiments of the invention provide devices and associated methods for use when performing endoscopic procedures. According to one aspect, a sheath positionable within a working channel of an endoscopic device, and adapted for receiving one or more instruments, is provided. The sheath can include a first channel and a second channel, the first channel and the second channel extending at least partially along a length of the sheath, wherein at least one of the first channel or the second channel includes an open edge open along at least part of the length of the respective channel.

Abstract: An endoscopic device for retrieving an object from within a human body is disclosed. The device includes a support assembly, a transmitting assembly, a wire, and a net element. The support assembly has a base and a tubular member. The transmitting assembly includes a handle and a motion transmitting link fixed to the handle and extending through at least a portion of the tubular member. The wire defines a loop portion and two leg portions. A proximal end of each leg portion is secured to the link by a first connection and the two leg portions are secured to each other by at least a second connection distal from the first connection. The net element has a distal portion secured to the loop portion and a proximal portion secured relative to the leg portions. The loop portion is movable between an expanded position and a collapsed position.

Abstract: An integrated guiding device has a tube and a corewire within the tube and a torque coupler. The torque coupler can couple the rotational motion of the tube with the rotational motion of the corewire. The wire can be moved longitudinally at least some amount relative to the tube. The device can further comprise a functional medical structure, such as an embolism protection structure. The device can be used in medical procedures, such as less invasive procedures within the cardiovascular system. Improved fiber based embolism protection devices comprise fiber bundles that are twisted prior to delivery.

Abstract: A surgical device for extracting material located internally within a patient including an actuator slidably positioned in a handle and movable relative thereto between a first position and a second position. A first flexible conduit having a first end coupled to the handle and defining a bore extending there through is coupled to the actuator. An actuation line having a first end coupled to the actuator and extending through the bore defined by the first flexible conduit is further included. A surgical instrument is coupled to a second end of the actuation line, upon movement of the actuator from the first position to the second position the surgical instrument moves from a retracted position within the bore defined by the first flexible conduit to an extended position wherein the surgical instrument extends at least partially from a second end of the first flexible conduit.

Abstract: Various embodiments of a surgical device that combines tissue cutting and spraying in a single device and related methods of use are disclosed. The device may include an elongated member having a proximal end and a distal end, an end effector proximate the distal end of the elongated member, and a nozzle member configured to substantially seal the distal end of the elongated member. The nozzle member may define a flow path in fluid communication between inside and outside of the elongated member when the distal end of the elongated member is sealed with the nozzle member.

Abstract: This treatment instrument includes: a flexible wire that has a first end part and a second end part, and that has a treatment part at an intermediate part for conducting treatment within a body cavity; small-diameter parts where at least a portion of the outer circumferential face of the wire has a smaller diameter or is denuded relative to the rest; a bundled part where the wire is bundled so as to at least include the small-diameter parts; and a manipulation wire that is connected to this bundled part.

Abstract: A thromboembolic removal system for treating ischemic stroke includes an elongate member and a receiver on a distal portion of the elongate member. The receiver includes structural members arranged to form a sleeve having a central lumen. A plurality of the structural members form engaging elements having apex regions that extend into the central lumen. During use of the thromboembolic removal system, the receiver is advanced over a body of thromboembolic material within a blood vessel, causing the body to be received into the central lumen, and causing the engaging elements to engage the body within the lumen.

Abstract: A medical device includes a tissue dissector and a snare loop on a common shaft. At least the distal tip of the snare loop is energizable to function as an electrosurgical element for tissue dissection. In use the snare loop is partially extended from the shaft to expose the electrosurgical element for electrosurgical dissection, and the snare loop is fully extended from the shaft to deploy the snare loop for retrieval and positioning of an implant such as a gastric banding device. The snare loop may be deployed through a pair of jaws also mounted on the shaft for use in tissue dissection.

Abstract: A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.

Abstract: An extensible polyp retrieval apparatus designed to be slidably disposed along the outer surface of an endoscope that is fully or partially inserted in the lumen of a patient using a “connect and push” polyp retrieval apparatus to reach the distal end of the inserted endoscope. The polyp retrieval apparatus comprises: a flexible cylindrical polymeric tube capable of being deployed from a few centimeters in mounted length on an endoscope to over 210 centimeters in total length when partially deployed or fully extended, respectively; a multiplicity of clamping fasteners permanently mounted to the flexible cylindrical polymeric tube; a movable snare like device that is designed as an cooperating component of the polyp retrieval system to enable the grasping and storage of polyps therein so as to avoid the complete removal of the endoscope from the lumen as is normal to remove a large polyp after cauterization or after a piecemeal polypectomy.

Abstract: A medical instrument captures and removes very large intraocular foreign bodies. The foreign bodies may have an irregular shape, a low coefficient of friction, and be made of non-magnetic materials. A fixed position hollow rod is mounted to a leading end of an elongate base and a lid is mounted to the distal end of the hollow rod. A control rod is slideably received within the hollow rod and a control knob slideably mounted on the elongate base is connected to the control rod to control extension and retraction of the control rod. A silicone basket depends from a rim formed at the distal end of the control rod. A silicone wire interconnects the hollow rod and a bottom of the basket so that the basket is drawn parallel to the control rod when the control rod is extended. The lid covers the basket when the control rod is retracted.

Abstract: A surgical instrument and method are provided for positioning an osteochondral plug within a bone defect site. The instrument includes an elongate shaft, a ribbon, an elongate sleeve and a locking mechanism. The shaft has proximal and distal ends, with the distal end being shaped to contact the osteochondral plug. The ribbon extends along two sides of the shaft and around the distal end, forming a loop that is used to secure the osteochondral plug to the distal end. The sleeve is movably mounted to the shaft for reciprocating relative thereto between retracted and extended positions. The sleeve includes a slot that allows for visualization and cutting of the ribbon. The locking mechanism locks the ribbon in place and thereby controls the size and tension of the loop that surrounds the osteochondral plug, securing it to the distal end of the shaft.

Abstract: Disclosed herein are devices and methods for forming multidirectional cuts in tissue. The tissue cutting devices disclosed herein generally include a flexible elongate member with at least first, second, and third wires that are at least partially constrained within or along a portion of the member. A distal portion of the wires is anchored on or within a portion of the elongate member. When tension is applied to at least one of the wires, such as by an actuator at a proximal end of the device, the elongate member bows while an unconstrained portion of the wire becomes exposed relative to the adjacent portion of the elongate member, assuming a tissue-cutting configuration.

Abstract: A medical instrument converts linear movement of a shaft at a proximal end of the instrument to a rotational movement of an end effector of the instrument. According to one embodiment, the medical instrument includes an end effector formed of a snare loop connected to a shaft that is located within a sleeve. Once the sleeve is located near a desired location within a patient, the snare loop may be rotationally positioned with linear movement of the shaft by the operator. The shaft is formed with a threaded portion that matches threads formed in a torque transmitter element fixed within the sleeve. Linear movement of the shaft through the torque transmitter element causes the shaft to rotate. The medical instrument may also include a pivot connector for reducing torque build-up of the shaft and/or a clutch assembly for restricting controlled rotation of the snare loop to only one direction.

Abstract: A tissue cutting device includes an insertion section which is inserted inside a specimen and extends from a distal end to a proximal end, openings which are formed in a distal end side of the insertion section inserted into the specimen, tissue cutting members which pass through the openings, extend such as to protrude in a direction intersecting the axial line of the length direction from the distal end of the insertion section to the proximal end, and are drawn into the insertion section from the same openings after forming a loop which tissue can be inserted into, a control member which is connected to the tissue cutting members, and a controller for controlling the control member; tissue passed through the loops being cut by controlling the control member and drawing the tissue cutting members from the openings into the insertion section.

Abstract: A thoracic closure device. The device has a handle member, a base member, and a feed path, and is designed to accept and, with a ratcheting mechanism, tension a toothed closure tie. A guide member is also provided, and assists in the placement of a closure tie prior to tensioning. Methods of closing a median sternotomy using toothed closure ties are also disclosed.

Abstract: An endoscope of an endoscope system includes a channel of which a distal end forms a distal opening at a distal end of an insertion portion, of which a proximal end forms a proximal opening at an operating portion, and used for at least suction, and a suction duct of which a distal end forms a suction opening at the operating portion and of which a proximal end is connected to a suction device. An endoscopic accessory includes a capture portion to be connected to an accessory insertion portion and detachably attached to the operating portion of the endoscope, and the capture portion includes a communication path to communicate the proximal opening with the suction opening when the capture portion is attached to the endoscope, and a capture unit interposed in the communication path and to capture the tissue being sucked from the channel into the suction duct.

Abstract: A tissue snare comprises an elongated member having a distal end and a loop formed of a shape memory material, the loop including a tissue receiving interior opening and being connected to the distal end of the elongated member, properties of the shape memory material being selected so that, when a temperature of the loop exceeds a critical temperature thereof, the loop constricts from an expanded state to a constricted state.

Abstract: A sphincterotome is disclosed including an elongate shaft having a lumen extending through at least a portion of the elongate shaft. The lumen includes a proximal segment and a distal segment. A cutting element extends within the lumen through the proximal segment of the lumen and extends exterior of the elongate shaft along the distal segment of the lumen. A stiffening member is positioned within the distal segment of the lumen.

Abstract: In a tissue removal device for receiving and removing body tissue from an interior portion of a body in a minimally invasive surgical procedure, the tissue removal device including a tubular body having a distal end, a proximal end and defining a lumen therethrough, a bag support structure configured and dimensioned to be receivable within the lumen of the tubular body, wherein the bag support structure has a first configuration for positioning within the lumen of the tubular body and a second configuration for opening a bag operatively coupled thereto, and a bag operatively coupled to the bag support structure, the bag including a first end portion defining an open end.

Abstract: A wire guide has first and second portions with first and second diameters, respectively. A resilient loop positions a distal end of the wire guide adjacent another section of the wire guide. A closure member comprising at least one attachment tab maintains the distal end in a fixed position relative to the remainder of the wire guide. A covering may be positioned around one or more parts of the wire guide.

Abstract: A medical instrument converts linear movement of a shaft at a proximal end of the instrument to a rotational movement of an end effector of the instrument. According to one embodiment, the medical instrument includes an end effector formed of a snare loop connected to a shaft that is located within a sleeve. Once the sleeve is located near a desired location within a patient, the snare loop may be rotationally positioned with linear movement of the shaft by the operator. The shaft is formed with a threaded portion that matches threads formed in a torque transmitter element fixed within the sleeve. Linear movement of the shaft through the torque transmitter element causes the shaft to rotate. The medical instrument may also include a pivot connector for reducing torque build-up of the shaft and/or a clutch assembly for restricting controlled rotation of the snare loop to only one direction.

Abstract: A medical instrument handle includes a medical-instrument-handle body, manually-slidable first and second slides, and medical-instrument-member first and second articulation cables. The handle body has a longitudinal axis, a proximal body portion, and a distal body portion. The first slide is slidably attached to the handle body. The first articulation cable includes a first proximal cable portion which has a first centerline and which is connected to the first slide. The second slide is slidably attached to the handle body. The second articulation cable includes a second proximal cable portion which is connected to the second slide. A medical instrument also includes a flexible shaft and a medical end effector.

Abstract: A surgical instrument and method are provided for positioning an osteochondral plug within a bone defect site. The instrument includes an elongate shaft, a ribbon, an elongate sleeve and a locking mechanism. The shaft has proximal and distal ends, with the distal end being shaped to contact the osteochondral plug. The ribbon extends along two sides of the shaft and around the distal end, forming a loop that is used to secure the osteochondral plug to the distal end. The sleeve is movably mounted to the shaft for reciprocating relative thereto between retracted and extended positions. The sleeve includes a slot that allows for visualization and cutting of the ribbon. The locking mechanism locks the ribbon in place and thereby controls the size and tension of the loop that surrounds the osteochondral plug, securing it to the distal end of the shaft.

Abstract: The invention relates to a direct reading endoscopic measuring instrument and, more specifically, to a manually operated measuring instrument that is placed in close proximity to an internal anatomical feature and a related method for operation of the measuring instrument. The direct reading endoscopic measuring instrument includes a distal reticule that is passed through an endoscope in a folded position. When extended past the distal end of the endoscope proximate to an anatomical structure to be measured, a remote actuator unfolds the reticule along an axis perpendicular to the endoscope. Graduations on the reticule can be observed to directly measure the size of the anatomical structure.

Abstract: A coupling wire guide structured to be slidably coupled to a previously introduced wire guide. The coupling wire guide includes a main body having a distal section. The distal section includes an outer wire disposed over a safety wire. A loop wire is connected to the safety wire at two axially spaced points. At least a portion of the loop wire is positioned outside of the outer wire to define a loop area sized to receive the previously introduced wire guide.

Abstract: The invention provides a method of using an apparatus for manipulating matter in a confined or inaccessible space, comprising providing an apparatus having manipulator means at least partly constructed of one or more bent or twisted elongate shape memory alloy members having pseudoelasticity at the intended manipulation temperature, and a hollow housing or cannula capable of holding at least the shape memory alloy member(s) in a relatively straightened state, and actuating means for extending the shape memory alloy member(s) from the housing to manipulate matter within the space and for withdrawing the shape memory alloy member(s) into the housing, the arrangement being such that the shape-memory alloy member(s) bend(s) or twist(s) pseudoelastically in a lateral or helical sense to manipulate the matter on extending from the housing at the manipulation temperature, and become(s) relatively straightened on withdrawal into the housing at the temperature.

Abstract: A snare injection device for performing endoscopic transection procedures is disclosed. The device includes a snare system and a needle system, each containing actuator components separately routed in one of two channels of an elongated dual lumen. Deployment of the snare and needle are independently operated by two separate handle controls. The device includes needle travel stop and anti-puncture features for safety and ease of use.

Abstract: A rigidizable surgical instrument comprises a rigidizable member, a first collapsible arm, a second collapsible arm, and a specimen retrieval bag for retrieving biological materials. The collapsible arms may be located at the distal end of the rigidizable member. The specimen retrieval bag may have an open end and a closed end, and may be configured to be retained upon the collapsible arms. The rigidizable member may include a rigidizing component to rigidize the rigidizable member when the state-change material or a stiffening element is in a rigid state. The rigidizable member may be rendered substantially rigid when the rigidizing component is actuated and the rigidizable member may be rendered substantially flexible when the rigidizing component is deactuated. A rigidizing mechanism for actuating the rigidizing component may include a vacuum. Various end-effectors may be provided in addition to the specimen retrieval bag.

Abstract: A medical retrieval device includes a basket formed of two or more loops. The basket may be used to retrieve material (e.g., a urinary stone) from a body. The basket opens and closes for end-encapsulation of a stone and is strengthened by support members that interconnect the basket loops. A captured stone may be released from the basket with the basket still in the body by opening the loops.

Abstract: The present invention provides apparatus and methods for retrieving an object from a body passage. In one embodiment, the apparatus comprises a first tube member, and optionally a second tube member. A proximal region of an arm is secured in place, while a distal region of the arm is coupled to a loop member of a snare. In use, proximal and distal advancement of a control member coupled to the loop member moves the loop member between collapsed and expanded states, respectively. In the collapsed state, the arm preferably does not extend radially beyond an outer diameter of the first tube member, thereby facilitating advancement of the retrieval device to a target site, e.g., via an endoscope. In the expanded state, the arm may move away from the first and second tube members, facilitate positioning of the loop member, and may facilitate capture of the object from the body passage.

Abstract: A device and system for removing tissue such as polyps is provided and includes a tubular member having proximal and distal ends, a snare portion operably extending from within the distal end of the tubular member and including first and second electrodes configured to treat tissue therebetween, the snare portion further including a cutting member for severing the treated tissue. The tissue removal device may further include a handle portion operatively extending from within the proximal end of the tubular member. The handle portion may be configured for operable engagement by a user and the cutting member may extend between distal ends of the first and second electrodes.

Abstract: A snare for retrieving objects from a body cavity during a medical procedure comprises a guide element having a proximal end and a distal end, a loop provided on the guide element near the distal end and a flexible element provided on the guide element near the distal end and forming a tip.