Abstract: A surgical milling cutter bracket includes a retaining base having a through hole. The upper part of the retaining base is provided with a finger guide having an L-shaped support frame on the top of the finger guide. A downward protrusion is provided at the end of the short side of the L-shaped support frame. The lowest point of the protrusion is lower than the lowest point of the cylindrical head of the milling cutter during normal operation of the milling cutter. A bolt having a through hole at the center is fixed within the cavity of the finger guide. A depressor is provided on the upper part of the retaining base. The bolt passes through a hole of the depressor and is connected to a nut. The protrusion is able to prevent an object from contacting the cylindrical head, thus avoiding cutting the object unevenly.

Abstract: A forceps includes first and second shafts, each having a jaw member disposed at a distal end thereof. At least one jaw member is moveable from an open to a closed position for grasping tissue therebetween. At least one jaw member is configured for reciprocation of a blade therethrough. A trigger assembly includes a trigger and at least one linkage coupled to the trigger and to the blade such that rotation of the trigger translates the blade between the retracted and the extended position. An interference member moveable between a locked position and an unlocked position is also provided. The interference member is configured to engage the linkage(s) when in the locked position to inhibit translation of the blade from the retracted to the extended position.

Abstract: A surgical instrument includes a housing supporting first and second actuators thereon, and an elongated shaft extending distally from the housing. First and second drive members extend through the elongated shaft to operatively couple respective actuators to respective jaw members such that independent manipulation of one of the actuators may induce pivotal movement of an individual jaw member. A locking member is operatively associated with the first and second drive members, and is selectively movable between locked and unlocked positions. When the locking member is in the locked position, the first and second drive members are coupled to one another and move concurrently to drive the jaw members in a bilateral manner. When the locking member is in the unlocked position, the drive members are decoupled from one another and move independently to permit operation of the instrument in a unilateral manner.

Abstract: A tissue harvesting and processing apparatus comprises a body and a distally extending needle. The needle includes an aperture configured to receive tissue. A tissue cutting member is movable relative to the needle to sever a specimen from tissue protruding through the aperture. A tissue processor is operable to mince tissue severed by the tissue cutting member. The minced tissue may be mixed with a medical fluid component contained in a reservoir. The medical fluid mixture may be expelled through an applier tip coupled with the body. The tissue processor may comprise a mincing die such that tissue specimens are minced upon being extruded through the mincing die. The tissue processor may comprise a blade that cooperates with a sliding press. The tissue processor may comprise auger blade sections that cooperate with inwardly extending pins. A mixing piston may mix the minced tissue with the medical fluid component.

Abstract: According to an aspect of the present invention, a medical device is provided, which comprises the following: (a) a hollow elongate body (e.g., an elongate cylinder, such as a needle) having distal and proximal ends; and (b) a rotatable member comprising a tissue morselizer and an elongate shaft (e.g., an auger-like tissue-drilling bit). The device (i) advance material (e.g., morselated tissue) toward the proximal end of the hollow elongate body when the shaft is rotated in a first direction, and (ii) advance material (e.g., a therapeutic agent and/or a bulking agent) toward the distal end of the hollow elongate body when the shaft is rotated in a second direction that is opposite the first direction. The invention also provides a method of treatment for morselizing and removing tissue from within the patient and creating a void within the patient and introducing a therapeutic agent and/or a bulking agent into the void.

Abstract: A surgical tool and monolithic frame therefore are disclosed. The monolithic frame defines a longitudinal axis between opposite first and second ends thereof, and is adapted to receive the flexible drive shaft of a surgical tool, and to support at an end thereof the rotary cutting tool of a surgical tool. The monolithic frame is characterized by greater flexibility in opposite directions along a first axis defined normal to the longitudinal axis than in opposite directions along a second axis defined normal to both the first axis and the longitudinal axis.

Abstract: A biopsy device includes a body having a cannula, a cutter positioned at least partly within the cannula, a tissue collection chamber, and a vacuum source. In one example, the biopsy device includes a cutter loader for rotating the cutter into a loaded position (e.g., open position). A trigger is engaged with a portion of the cutter loader and may be activated to allow the cutter to rotate back to a closed position. During this rotation, the cutter severs a tissue sample, which may thereafter be drawn through the cutter lumen into the tissue collection chamber under the influence of a vacuum created by the vacuum source. The vacuum source includes a piston configured to be operated by squeezing a scissors grip. A user may apply a single stroke or successive strokes to the piston to produce the vacuum.

Abstract: The present invention relates to a device with an ultrasonic-based probe for drilling and coring. The invention uses ultrasonic and subsonic vibrations produced by a frequency compensation coupler or free mass to produce the hammering action of a partially disengaged probe, with a relatively low axial force required. The invention can also be fitted with irrigation and aspiration capabilities. The invention can furthermore be furnished with a body sensor-feedback apparatus, which provides feedback to the operator as to the optimal frequency and power use of the generator. One embodiment of the invention also has a cooling mechanism to keep the drill or coring apparatus at an optimum temperature.

Abstract: A catheter system for positioning an instrument within a body that includes a hub defining a lumen therethrough for passage of the instrument toward the body. The catheter system also includes an elongate tubular member defining a lumen therethrough. The lumen of the elongate tubular member is in communication with the lumen of the hub for further passage of the instrument toward the body. The system also includes a slitter member that is coupled to the hub. The slitter member is disposed to slit the elongate tubular member as the elongate tubular member moves relative to the hub.

Abstract: An atherectomy system having a variably exposed cutter wherein a distally located positionable tip closely associated with the cutter and a high pressure fluid jet emanator can be variably and angularly deployed about a hinge mechanism subsequent to entry into the vasculature. The fixed cutter slices or parts atheromatous material and/or thrombotic material from a blood vessel for interaction with high pressure jets to macerate, break up or otherwise reduce the materials for evacuation from the site.

Abstract: According to an aspect of the present invention, a medical device is provided, which comprises the following: (a) a hollow elongate body (e.g., a elongate cylinder, such as a needle) having distal and proximal ends; and (b) a rotatable member comprising a tissue morselizer and an elongate shaft (e.g., an auger-like tissue-drilling bit). The device (i) advances material (e.g., morselated tissue) toward the proximal end of the hollow elongate body when the shaft is rotated in a first direction, and (ii) advances material (e.g., a therapeutic agent and/or a bulking agent) toward the distal end of the hollow elongate body when the shaft is rotated in a second direction that is opposite the first direction. The invention also provides a method of treatment for morselizing and removing tissue from within the patient and creating a void within the patient and introducing a therapeutic agent and/or a bulking agent into the void.

Abstract: Apparatuses and methods for accessing and disrupting a tissue are disclosed herein. In one embodiment, an apparatus includes a first elongate member having a tissue interaction portion disposed at a distal end of the first elongate member. The tissue interaction portion is configured to be inserted within a biological body. A second elongate member is movably disposed within a lumen defined by the first elongate member. The second elongate member has a threaded exterior surface. A drive motor is coupled to the first elongate member and coupled to the second elongate member. The drive motor is configured to rotate the first elongate member in a first direction and configured to rotate the second elongate member in a second direction opposite the first direction. The tissue interaction portion is configured to disrupt tissue when disposed into the biological body and when the first elongate member is rotated.

Abstract: Devices and methods for varying the size of a tissue sample in a biopsy device are disclosed. The biopsy device includes a needle with a tissue aperture and an inner cutter which translates within the needle. The inner cutter may be controlled to selectively block the aperture thereby varying the sample size. A half cylindrical sleeve may be resiliently attached to the exterior of the needle in order to block the aperture. The sleeve includes gripping flanges on its bottom surface, and a beveled distal tip configured to avoid damage from the inner cutter. The distal tip may include an inner metallic guide or may be heightened to avoid contact with the cutter.

Abstract: The present invention provides a biopsy instrument with improved needle penetration for piercing dense tissue. The device may comprise a needle slidably retained in a housing. The device may further comprise an actuation member that may be adapted to communicate longitudinal motion to the needle in a first direction. The device may further include a propulsion element that provides the needle with return motion in a second direction. The device may be fired multiple times to create repeating reciprocal motion. In one version, the device may reciprocate several times as a result of a single engagement of the actuation member.

Abstract: A disc space preparation device that has particular application for removing disc material during spinal fusion surgery. The disc preparation device includes a body portion that houses a motor having a shaft attached thereto that is rotated by the motor. The shaft extends through a chamber in a neck portion of the device and into an open head portion of the device at the end of the neck portion opposite to the housing. The head portion rotates relative to the neck portion. The head portion includes a series of blades that are used to cut-away the disc material. The shaft includes an auger that draws the cut material through the neck portion. A suction port is coupled to the chamber in the neck portion to remove the disc material therefrom.

Abstract: An assembly structured to introduce a trocar or other medical instrumentation into a body cavity through an entry site formed in the cavity wall. The introducer assembly includes a base formed of a semi-rigid, flexible and/or a semi-flexible material having an instrument receiving passage extending there through, and further including an exterior sealing surface extending between proximal and distal portions of the base. The sealing surface has a predetermined configuration which is shaped to conform to the shape of the entry site as the base passes into the entry site. A fluid restricting seal is thereby established between the exterior of the base and the peripheral tissue surrounding the entry site, particularly when the entry site is formed by an incision commonly utilized an open laparoscopic procedure.

Abstract: An ablation burr for a rotational atherectomy device that may reduce the risk of damage to a vessel wall while providing ablative cutting surfaces out to the maximum diameter of the burr. Two different abrasive surfaces are provided on the leading surface of the ablation burr. A less aggressive or finer abrasiveness is provided near the ablation burr maximum diameter, which is the portion of the burr nearest the vessel wall. This portion of the burr also presents a relatively shallow angle of attach to the vessel wall. A more aggressive or coarser abrasive is applied to portions of the burr disposed further from the vessel wall. In one embodiment, the more aggressive abrasive portion of the burr has a concave profile, thereby further reducing the possibility that the more aggressive abrasive will contact the vessel wall, even when the burr is rotated significantly away from the vessel axis.

Abstract: Apparatus and methods for treating in-stent restenosis are described for removing stenotic material from within previously stented regions of a patient's vasculature. The apparatus includes a catheter system having a stenotic material removal mechanism mounted on a distal portion of an elongated inner catheter. A sensing means, such as one or more sensing electrodes, are positioned on an outer surface of the apparatus. In addition, the apparatus optionally includes control means for diametrically expanding the stenotic material removal mechanism for effective recanalization of the stent. A coaxial outer catheter is provided for aspirating stenotic material which is removed from within the stent. In addition, embolic filter apparatus are described for collecting the stenotic material removed from within the stent.

Abstract: An ablation burr has a body provided with an inner circumferential rim and an outer circumferential rim that are concentric and spaced longitudinally by a selected distance along the length of the burr. The outer circumferential rim has a generally smooth convex outer surface that reduces damage to a vessel wall or stent A leading surface of the burr extends between the inner and outer circumferential rims in a substantially uniform, concave manner. An abrasive, for example, diamond grit, is provided on the leading surface. The burr is selectively rotated by a drive shaft, causing the abrasive leading surface of the burr to ablate unwanted deposits. If desired, a wire extends co-axially through the body such that a distal end of the wire extends out of the distal end of the burr. An abrasive tip may be coupled to the distal end of the wire, and is selectively rotated, to ablate unwanted deposits.

Abstract: An atherectomy device that may reduce the risk of damage to a vessel wall. One rotatable atherectomy burr has a recessed material removal portion lying between less abrasive proximal and distal shoulders. The shoulders can have a straight, rounded or elliptical taper. The shoulders can perform a cam action when the burr is canted is a vessel, as when passing the burr and guide wire through a tortuous, stenosed vessel path. The shoulders act to align the burr with the path through the vessel, presenting the less abrasive shoulders to the vessel wall while presenting the abrasive portion to a stenosis.

Abstract: A convertible rongeur is shown, with a top shaft that opens from the front, to allow access for cleaning, yet remains attached to the body of the device even when fully opened. In the preferred embodiment, the top shaft of the rongeur is held in positive engagement with the front handle piece of the rongeur by means of a spring loaded, retractable slot and pin linkage, and the permanent attachment between the top shaft and the remainder of the instrument is through a movable linkage at the rear. The rongeur is thus fully openable for cleaning, yet remains in one piece when opened for cleaning, and retains all of the advantages of permanently assembled prior art rongeurs.

Abstract: A scalpel is provided with horizontally separated first and second scalpel blades and with manually operated devices to adjust the separation between the blades as desired.

Abstract: A subcutaneous tunnelling device, a dilator and a method of forming a subcutaneous tunnel are provided. The device includes a trocar having a front end with a point configured for piercing skin, and a dilator which has a front end removably attached to the rear end of the trocar. The dilator is for dilating a section of a subcutaneous tunnel and includes a dilating section having a maximum diameter sized for dilating an interior surface of a subcutaneous tunnel for seating a catheter stabilizing cuff in the subcutaneous tunnel. The method of forming a subcutaneous tunnel includes the steps of inserting a trocar through a first location on a cutaneous surface and moving the trocar through subcutaneous tissue to form a subcutaneous tunnel. The trocar is at least partially removed and a front end of a dilator is attached to the trocar. A section of the tunnel is dilated by moving the dilator partially through the tunnel until the front end of the dilator reaches a first subcutaneous location in the tunnel.

Abstract: A surgical instrument includes a proximal actuation handle and a flexible guiding catheter having a channeling lumen, a suction lumen, and a control lumen. The guiding catheter has a slit opening into the control lumen at its distal end. A hollow cutting member extends through the channeling lumen and is moveable distally relative to the guiding catheter with a cutting actuation mechanism. The cutting member is preferably a section of thin walled hypodermic tubing having a sharpened distal end and is provided with a first proximal connector for coupling the cutting member to a first pressure regulator. A flexible control wire extends through the control lumen and is movable distally and rotatably relative to the guiding catheter with a control actuation mechanism. The control wire is sufficiently flexible to buckle with each contraction of the heart and has a foot at its distal end located beyond the distal end of the guiding catheter and movable relative thereto by movement of the control wire.

Abstract: An ultrasonic surgical instrument is described for use in medical procedures to, for example, dissect or cut living organic tissue. The ultrasonic surgical instrument includes an outer sheath, a waveguide, and an improved acoustic isolation element. The acoustic isolation element is bonded to both the ultrasonic waveguide and the interior surface of the outer sheath, creating an acoustic isolation seal. The improved acoustic isolation element seals the distal end of the ultrasonic instrument, substantially improving its ability to reduce or eliminate penetration by liquids or other contaminants during, for example, soaking or steam autoclave sterilization.

Abstract: A motorized pierced body part cleaning device includes a substantially hollow, elongated tubular handle component having an open end and a plurality of cleaning stem gripping members at a distal end. The cleaning stem gripping members are selectively rotated using an electric motor disposed within the tubular handle. Integral with the tubular handle adjacent its open end is a storage reservoir for storing a plurality of cleaning stems in a cleaning or disinfecting solution. The open end may be selectively enclosed using a cap means.

Abstract: This disclosure sets out a catheter for bodily insertion. The catheter tip supports an elongate hollow housing with a window for occlusive material cutting, a cutter head on the interior rotates, driven by a drive wire in the hollow catheter tube. In addition, the cutter head reciprocates or oscillates to cut on its back edge, the edge trimming material entering through the window. The window and optional slots admit the unwanted material and enable trimming for a vacuum removal through the catheter tube. The window is urged into contact by a pair of flexed wires, the wires moving the housing into operative contact.

Abstract: A method and apparatus for endoscopic removal of compliant biological tissues utilizing an endoscopic ultrasonic aspirator comprising irrigation and aspiration means, a piezoelectric ultrasonic transducer, a first resonator such as a half-wave stepped velocity transformer, a probe including a second resonator such as a constant-stress velocity transformer, a blunt or modified working tip of open channel means or restricted tubular means for application of ultrasonic energy to cellular material, and a capacitive fluid sensor to detect the presence of irrigation fluid adjacent these transformers within the instrument. The surgery is advantageously performed by operating the transducer in the 10-20 kHz range to achieve maximum cavitation of the intracellular fluids in the tissues to be removed.