Abstract: An interchangeable tip comprising: a stylet; a blade module including: an enclosure that electrically connects, signally connects, or both the interchangeable tip to a power source, a signal source, or both; and blade circuitry having: one or more control buttons, one or more switches, or both for controlling operation one or more functions of the interchangeable tip.

Abstract: A remote control actuator includes a spindle guide section (3), a distal end member (2) fitted to the tip of the spindle guide section for alteration in attitude, a tool (1) provided rotatably in the distal end member, a tool rotation drive source (41) for rotating the tool, and an attitude altering drive source (42) for altering the attitude of the distal end member. The spindle guide section has therein a rotary shaft (22) for transmitting a rotation of the tool rotation drive source to the tool, and an attitude altering member (31) capable of being selectively advanced or retracted by the attitude altering drive source for altering the attitude of the distal end member. A position detector (47) is provided for detecting the advanced or retracted position of the attitude altering member at a site distant from the attitude altering drive source.

Abstract: An end effector includes a first jaw and a second jaw, the first jaw movable relative to the second jaw to transition the end effector between an open configuration and an approximated configuration to clamp tissue therebetween. The end effector may also include a camming assembly movable along a curved path. The camming assembly includes a first camming member which includes a first distal camming portion, a first proximal camming portion, and a first flexible portion extending between the first distal camming portion and the first proximal camming portion. The camming assembly includes a second camming member and a connector at least partially disposed between the first camming member and the second camming member, wherein the camming assembly is movable relative to the end effector to exert a camming force against the first jaw and the second jaw to transition the end effector to the approximated configuration.

Abstract: A method for removing at least part of a brain tumor may first involve contacting a forward-facing tissue cutter disposed at the distal end of a tissue removal device with the brain tumor. The tissue removal device may include a shaft having a diameter no greater than about 10 mm, and in some embodiments the tissue cutter does not extend laterally beyond the diameter of the shaft. The method may next involve cutting tissue from the brain tumor, using the tissue cutter. The method may then involve moving the cut tissue through a channel of the shaft in a direction from the distal end of the tissue removal device toward a proximal end of the device.

Abstract: A surgical apparatus is provided. The surgical apparatus includes a housing that supports a shaft assembly. The shaft assembly defines a longitudinal axis therethrough and includes coaxially aligned outer and inner shaft members. The inner shaft member is movable within the outer shaft member. An end effector includes a pair of jaw members disposed at a distal end of the outer shaft. At least one of the jaw members is pivotably coupled to the outer shaft and is movable between open and clamping configurations for grasping tissue. The inner shaft contacts a proximal end of the moveable jaw member to maintain the movable jaw member in the open configuration and is slidable against the movable jaw member to move the moveable jaw member between the open configuration and clamping configuration.

Abstract: A bendable medical device such as for removing tissue from a subject is provided with a distal housing, an outer support tube, an inner drive tube, a coupler and a commutator portion. The coupler and commutator portion serve to axially constrain a distal end of the inner drive tube during bending, and to supply fluid for lubricating, cooling and irrigating the distal end of the device.

Abstract: A medical device such as for removing tissue from a subject is provided with a distal housing configured with a tissue cutter assembly, an elongate member coupled to the distal housing and having an outer tube and an inner drive tube with a crown gear located on a distal end thereof, first and second rotatable members each rotatably mounted to the tissue cutter assembly, a first drive gear train coupled between the crown gear and the first rotatable member, and a second drive gear train coupled between the crown gear and the second rotatable member. The first and second drive gear trains are configured to drive the first and second rotatable members, respectively, in opposite directions. Concave and convex gear tooth profiles are also disclosed for improved performance of the first and second drive gear trains.

Abstract: Provided herein is a method for treating spinal stenosis comprising percutaneously accessing the epidural space from a first side of the spine. The first side of the spine is located on one side of the medial plane with respect to the spinal cord. A tissue removal tool is then advanced through the first side of the epidural space into the other side of the epidural space, where the other side of the epidural space is located on the other side of the medial plane of the spinal cord. Once the tissue removal tool is located on the second side of the medial plane, stenosis can be reduced using the tissue removal tool.

Abstract: An ultrasonic surgical instrument includes a body such as a handle assembly and an acoustic transmission assembly. The acoustic transmission assembly includes an ultrasonic transducer and an end effector. A mounting ring is positioned on a horn of the transducer. A rotatable drum is positioned distal to the mounting ring. Piezoelectric components of the transducer are positioned proximal to the mounting ring. Electrical conduits extend from the drum to the piezoelectric components and are routed over or through the mounting ring. The drum is coupled with a power source through a slip ring assembly to selectively activate the transducer.

Abstract: A dual port ablation cannula kit includes a trocar and a hollow shaft defining a longitudinal lumen. The shaft has a proximal segment and a distal segment, such that the distal segment includes a distal tip substantially aligned with the shaft to permit passage of the trocar within the hollow shaft. The distal tip also is configured with a tissue-gripping surface in as much as a plane of the tissue-gripping surface is substantially perpendicular to a longitudinal axis of the shaft, dual ports extending from an exterior surface of the hollow shaft, each port defining a hollow passageway into the hollow shaft, and dual couplers, one coupling a suction line to one of the dual ports and another coupling an irrigation line to another of the dual ports. Finally, the kit can include a laser fiber.

Abstract: A forceps comprising: (a) a stylet comprising; (i) a hollow tube having a longitudinal axis; (ii) assemblies, that are extendable through the hollow tube, comprising; (1) support rods; (2) functional attachments at the end of the support rods; (b) a hand piece comprising; (i) housing structures defining a cavity that houses the stylet; (ii) actuating mechanisms, in communication with the stylet, comprising; (1) a bearing fitting located on the stylet; (2) a shuttle in communication with the bearing fitting, and constrained by a plurality of guide ridges so that the shuttle is movable along a longitudinal axis and restricted from rotational movement around the longitudinal axis; (3) a socket housed by the shuttle, the socket receiving the bearing fitting and being rotatable relative to the shuttle; and (4) levers in communication with the stylet that causes movement of the hollow tube and the assemblies are relative to each other.

Abstract: Featured is a surgical instrument having an elongate inner tubular member and an elongate outer tubular member, in which the inner tubular member is moveably received within the outer tubular member. The instrument also includes a diamond-like carbon (DLC) surface disposed so as to be between the inner and outer tubular members. In further embodiments, the DLC surface is formed on the outer surface of the inner tubular member and/or on the inner surface of the outer tubular member. In yet further embodiments, the inner tubular member includes a cutting edge disposed at a distal region thereof, and the outer tubular member includes a distal opening therein. The opening is positioned to expose and co-operate with the cutting edge of the inner tubular member to permit shearing or cutting of tissue.

Abstract: A small gauge surgical instrument assembly is shown with advantages such as diminished “play” at the tip. A surgical instrument assembly is also shown with support along a length of the instrument that can be selected by the surgeon. In particular, very small and flexible instruments for vitreous surgery are shown with selectable stiffness, thus providing control as well as access to all parts of the vitreous cavity. Embodiments as shown are safer, and increase the variety of cases for which these instruments can be used.

Abstract: Disclosed herein is a system for releasing a ligament. In one embodiment, the system includes a proximal handle, a tubular body, and a flexible body. The tubular body includes a proximal end and a distal end. The handle is coupled to the proximal end. The flexible body extends through the tubular body and includes a tissue cutting portion. The flexible body or tubular body is longitudinally displaceable to move the tissue cutting portion between a non-deployed state and a deployed state.

Abstract: A medical device for removing tissue from a subject is provided with a distal housing, an elongate member, a first rotatable member and first and second tissue shearing surfaces. The distal housing is configured with at least one tissue engaging opening. The elongate member is coupled to the distal housing and configured to introduce the distal housing to a target tissue site. The first rotatable member is located at least partially within the distal housing. The first and second tissue shearing surfaces are located and configured to cooperate with first and second sides of a first blade to shear tissue therebetween. The first rotatable member is configured to engage tissue from the target tissue site, rotate towards the first and second tissue shearing surfaces and inwardly to direct tissue from the target tissue site through the tissue engaging opening and into an interior portion of the distal housing.

Abstract: A biopsy device includes a probe, a holster, and a tissue sample holder for collecting tissue samples. The probe includes a needle and a hollow cutter. The tissue sample holder includes a housing having a plurality of chambers that are respectively configured to receive a tray. The housing is releasably engageable with the probe. Each tray is configured to receive a tissue sample communicated through the cutter lumen. Each tray is removable from the housing, such as along an axial direction. The tissue sample holder is rotatable to successively index each chamber to the cutter lumen. A tray retainer is operable to selectively secure the trays relative to the housing. The trays may be flexible, resilient, or rigid.

Abstract: A tissue treatment device comprises a housing having a chamber that receives a treatment fluid mixture of tissue morsels and a scaffold material. A debriding shaft including a plurality of cutters is coupled with the housing. The debriding shaft extends proximally within the chamber and extends distally from the end of the housing. The debriding shaft is inserted within a treatment site such as a fistula tract and is rotated and reciprocated such that the debriding shaft removes tissue cells along the site. The site is flushed with saline or other irrigating fluid followed by application of the treatment fluid mixture. The chamber of the housing comprises agitators positioned adjacent the debriding shaft. The treatment fluid mixture passes through the chamber of the housing along and between the outer surface of the debriding shaft and the agitators for thorough mixing before exiting the device at the treatment site.

Abstract: A laparoscopic scalpel includes a shaft and a recess disposed in a surface of the shaft proximal to a distal end of the shaft. A blade is attached to the shaft. The blade includes a cutting edge having a portion exposed by the recess and oriented outwardly from the recess. A proximal end of the portion of the cutting edge exposed by the recess is disposed further from the surface than is a distal end of the portion of the cutting edge exposed by the recess.

Abstract: A surgical instrument includes a housing and an elongated shaft having a distal portion and a proximal portion coupled to the housing. The elongated shaft defines a longitudinal axis and a mandrel at the proximal portion. An inner shaft member extends at least partially through the elongated shaft. An actuating mechanism is operably coupled to the mandrel and is configured to selectively cause movement of the elongated shaft in a longitudinal direction with respect to the inner shaft member. The surgical also includes an end effector that is adapted for treating tissue and includes an upper jaw member pivotally coupled to a distal portion of the inner shaft member about a pivot axis and a lower jaw member supported by the distal portion of the elongated shaft. Longitudinal movement of the elongated shaft is configured to pivot the upper jaw member relative to the lower jaw member.

Abstract: A tissue cutting device is disclosed, which is structured and arranged to be inserted through the vascular system into a body vessel adjacent to the heart and/or into the heart, and to be subsequently subjected to a change of shape in order to penetrate into the heart tissue. The tissue cutting device may thus be used for treating disorders to the heart rhythm regulation system. A kit of devices provides a plurality of devices for creating a lesion pattern for treating such disorders.

Abstract: A wound debridement instrument for treatment of chronic wounds has an elongate handle with a distal end, a proximal end, and a middle section. An elongate tubular blade body extends distally from the handle distal end and terminates at a distal cutting edge. The tubular body defines a cavity and has a longitudinal axis. The distal cutting edge follows the arc of the tubular body and is angled relative to the longitudinal axis. In some embodiments the tubular body is an incomplete tube, having a longitudinally-extending gap formed therein. Some embodiments may also have a scraping element extending proximally from the handle proximal end.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: An endoscopic surgical blade is disclosed. The blade is of a hook design, having an upper cutting surface located on the trailing edge of an arm and a lower cutting surface on the upper edge of the main body of the blade. The blade is part of an endoscopic knife assembly which also contains a knife tube and alignment ring. The endoscopic knife assembly is for use in endoscopic surgery by insertion of the assembly through a slotted cannula. The knife tube is hollow and allows the insertion of an endoscope for viewing of the surgical procedure. A method for a performing an operative procedure on a target tissue in a subject using an endoscopic knife assembly having a hook blade is also described.

Abstract: Various medical devices and methods for cutting, evacuating and/or performing work on tissue are provided. The devices and methods may utilize a reciprocating mechanism or motor powered by suction from a vacuum source. The medical devices and methods may be used on tissue in various regions of a patient's body and for treating various conditions, e.g., for performing a polypectomy.

Abstract: An apparatus for performing a transesophageal cardiovascular procedure includes an elongated tubular main access device having a first lumen with an open proximal end and a distal side opening, and a second lumen with a rigid outer wall and a collapsible inner wall. The second lumen is adapted to receive an elongated probe or surgical device. The apparatus further includes an inflatable sealing means on the outside of the main access device above and below the side opening, and a first fluid conduit extending along the main access device for inflating the sealing means so that when the main access device is inserted into a patient's esophagus and the sealing means are inflated. The portion of the esophagus opposite the side opening is isolated from the remainder of the esophagus above and below the side opening.

Abstract: The invention pertains to a method, apparatus, and system for cutting anatomic members, such as ligaments, in surgical procedures such as carpal tunnel release, plantar fasciotomy, gastroc release, cubital tunnel release, and tarsal tunnel release. The apparatus includes a retrograde knife and a guide tool for guiding the knife and a scope during surgery. Relevant features include a knife stop for preventing the knife from inadvertently raising out of the knife channel, indicators showing the proper orientation for the guide tool, a self dilating tip and channel design on the guide tool, a cover piece and/or pivotable panel system for preventing ligaments and other anatomy from getting caught in the guide tool, a pivot pin and groove system for stabilizing the knife and also assuring that the knife blade is not inadvertently raised out of the channel, and a use indicator for preventing re-use of a single use device.

Abstract: Surgical apparatus, including a trocar having a tubular member with a tubular member distal end and a tubular member proximal end. The apparatus further includes a tool having a tool proximal end and a tool distal end. The tool is insertably disposed within the tubular member with the tool distal end projecting beyond the tubular member distal end. The apparatus further includes an indicator indicating the tool distal end while the tool distal end projects beyond the tubular member distal end.

Abstract: A variable-frequency stimulator for electrosurgery includes an impedance analyzer to identify the electrical impedance of biological tissue being treated by an electrosurgical instrument, such as a laparoscope. Based on the identified tissue impedance, a controller adjusts the frequency of electrical current delivered to the electrosurgical instrument to reduce, minimize or normalize the impedance of the tissue, thereby preventing collateral damage to the tissue in and about the surgical site. Additionally, the laparoscope may be configured with multiple electrically conductive grasping arms that are used to deliver the electrical current to the surgical site. The conductive grasping arms provide multiple current paths for the electrical current to flow, thus concentrating the electrical current at the surgical site during an electrosurgical procedure.

Abstract: A surgical endoscopic cutting device includes cutting elements fitted in a protective tube. The device has an inlet for fluid, a discharge outlet for tissue and fluid, and a further outlet that discharges most of the fluid.

Abstract: A laparoscopy tool includes a sheath and a control wire slideably disposed within a lumen of the sheath. The sheath has a diameter of less than 1.6 mm and is introduced through an abdominal incision. A handle axially displaces the control wire within the lumen and operates a conventional tip with wire-controlled opposing jaws that is introduced through the umbilicus and has a bore formed in its trailing end. A first set of blades in the bore engage grooves formed in the leading end of the control wire and a second set of blades engages the sheath to prevent sheath retraction. A cam displaces the second set of blades away from the sheath for sheath introduction and removal, and toward the sheath to prevent sheath retraction. The tip is removed through the umbilicus and the tool is removed through the abdominal incision when the surgery is completed.

Abstract: An endoscopic surgical device comprising a slotted clear cannula, a blade and a case, wherein the cannula is attached to the case, and wherein the blade is enclosed in the case and is slidable into the cannula is disclosed. The blade is enclosed within the case and cannula, and has a horizontally-oriented pushing component and a vertically-oriented cutting component that protrudes through the slot of the cannula. A method for a performing an operative procedure on a target tissue in a subject using the endoscopic surgical device is also described.

Abstract: An endoscopic surgical device having a slotted clear cannula, a blade and a housing, wherein the cannula is attached to the housing, and wherein the blade is enclosed in the housing and is slidable into the cannula is disclosed. The blade is enclosed within the housing and cannula, and has a horizontally-oriented pushing component and a vertically-oriented cutting component that protrudes through the slot of the cannula. The device further has a device for locking a viewing device in place relative to other components of the device. A method for a performing an operative procedure on a target tissue in a subject using the endoscopic surgical device is also described.

Abstract: An endoscopic surgical device comprising a slotted clear cannula, a blade and a housing, wherein the cannula is attached to the housing, and wherein the blade is enclosed in the housing and is slidable into the cannula is disclosed. The blade is enclosed within the housing and cannula, and has a horizontally-oriented pushing component and a vertically-oriented cutting component that protrudes through the slot of the cannula. A method for a performing an operative procedure on a target tissue in a subject using the endoscopic surgical device is also described.

Abstract: A method of measuring conditions of an ultrasonic instrument includes providing an ultrasonic instrument that includes an end effector and a waveguide operably coupled to a generator and the end effector. The method involves generating one or more pulses with the generator, transmitting the one or more pulses to one or both of the waveguide and the end effector, generating one or more waves that scatter in an interferential pattern in response to the transmission of the one or more pulses, registering a signal indicative of the interferential pattern, generating an actual interferential pattern based upon the signal, and identifying one or more conditions of the end effector based upon the actual interferential pattern.

Abstract: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on (or formed from) rungs that are flexibly connected. The rungs are typically rigid, somewhat flat and wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used. The blades (on the rungs) may be arranged in a staggered arrangement. A tissue-collection or tissue capture element may be used to collect the cut or modified tissue.

Abstract: A surgical instrument includes a cutting member with an implement for cutting tissue, and a drive coupled to the cutting member to simultaneously rotate and translate the cutting member in response to a force applied to the drive. A method of cutting tissue includes positioning an outer member such that tissue is located within the outer member, engaging the tissue with an inner member, and simultaneously rotating and translating the inner member to cut the tissue. A tangential cutting force is applied to the tissue with the inner member to mechanically cut the tissue. The inner member is mechanically driven to undergo simultaneous rotation and translation.

Abstract: A surgical penetrating system includes a cannula and an obturator. The cannula has an outer wall arranged about a longitudinal axis and a longitudinal opening. At least one substantially linear penetrating member is mounted with respect to the outer wall of the cannula and extends in a general longitudinal direction with respect to the longitudinal axis. The penetrating member is adapted to facilitate passage of the cannula through tissue. Another embodiment of the surgical penetrating system includes a cannula having a longitudinal bore and a penetrating member at least partially and slidably mounted within the longitudinal bore of the cannula. The penetrating member has at least one leg and is axially movable between non-deployed and deployed positions. Moreover, the penetrating member can be mounted for movement relative to the leading end of the cannula and within the longitudinal bore of the cannula between a non-deployed position and a deployed position.

Abstract: A full-thickness resection system is disclosed. In an embodiment for the resection system, the system may include a flexible shaft, a flexible guide member disposed within the flexible shaft, a stapling mechanism disposed around the flexible guide member, and a grasper. The stapling mechanism has an elongated portion that is at least partially disposed within the flexible shaft. The stapling mechanism includes a stapling arm and an anvil arm. The stapling arm has a longitudinal axis and includes a stapling head having a longitudinal axis. The anvil includes an anvil head. The stapling arm and anvil arm extend from the elongated portion of the stapling mechanism and are moveable with respect to each other between a tissue receiving position and a stapling position. The grasper extends through the flexible shaft and is adapted to grasp a portion of a tissue that is to be excised from an organ in the patient's body.

Abstract: The present invention provides an apparatus for, and a method of, accurate positioning of endoscopic instruments. Accurate positioning of the instruments is accomplished through the inclusion of a steering ability within the device. After the endoscopic instrument is properly positioned, the present invention may use rapid exchange technology, soft locks, and mechanical locks to maintain the position of the endoscopic instrument. Rapid exchange technology is used to minimize displacement forces present on the guidewire or catheters. Soft locks and mechanical locks resist movements caused by displacement forces.

Abstract: A surgical instrument including a main unit and a suction conduit. The main unit includes at least one tubular body having a distal end, a proximal end, and an inlet disposed near the distal end. The suction conduit is slidably disposed over the main unit, and is slidably movable along the main unit between a retracted position, at which the suction conduit does not cover the inlet of the main unit, and an extended position at which the suction conduit covers the inlet of the main unit and a suction inlet of the suction conduit is placed in fluid-communication with the main unit inlet. The surgical instrument can be used as a suction tool by placing the suction conduit in the extended position and applying a vacuum through the inlet of the main unit and the suction inlet.

Abstract: Systems and methods for treating disc herniation include surgical and endoscopic access and removal of disc tissue. The tissue removal devices that may be used include flexible elongate members, such as a cable, that may be inserted into a vertebral disc and rotated to pulverize the disc material and facilitate its removal.

Abstract: A surgical instrument includes an elongated tube having a proximal end and a distal end, a handle coupled to the proximal end of the tube, and a tool that is rotatable and translatable relative to the tube, wherein the handle includes a control for rotating the tool relative to the tube, and wherein the control is coupled to the tool such that a movement of the control through an angle ?c rotates the tool relative to the tube by an angle ?t that is greater or less than ?c, and wherein the angle ?c is variable as determined by a user.

Abstract: A cutting knife allows multiple different blade tips to be removably attached to a handle. The handle may be a pen-type handle that uses an activation button to move a spring-loaded plunger between an extended and a retracted position, typically using a cam and cam follower. The interchangeable blade tips may use spring-loaded cutting blades that retract, and preferably lock, within a sheath when a plunger is not pushing the blade into an extended position. Thus, the cutting blade is safely stored within the sheath when the plunger is retracted, as well as when the interchangeable blade tip is detached from the handle. The interchangeable blade tips may be disposable or reusable. The cutting knife may be configured as a surgical scalpel in which the cutting blade is a scalpel blade. In such applications, the pen-type handle may be of autoclavable materials so that it may be reusable after sterilization.

Abstract: Devices and methods for creating holes in the articular process of the vertebra are provided. One embodiment of the invention comprises a drill head comprising a frame, punch arm with punch tip and opposing plate. Methods of using the resulting holes to anchor or stabilize facet joint prosthesis, and also altering the spacing and motion at the facet joints of the vertebral column, are provided.

Abstract: A morcellator (1) for morcellating tissue within a body cavity of a patient is provided in combination with first (17) and second (18) tissue-pulling devices, and an insert (19). The morcellator (1) comprises a handle portion (2) having a lumen (6) passing therethrough, and an aperture (10) communicating with the proximal end of the lumen. A tube (3) extends from the handle portion and has a tissue cutting device (7) located at the distal end of the tube. The handle includes first (11) and second (12) valves associated with the lumen of the handle portion, and the first and second tissue-pulling devices have shafts of a first diameter and second diameter respectively. The insert (19) comprises a stem (21) and a body portion (20), the stem being received in the aperture (10) to form a substantially gas-tight seal in combination with the first valve (11).

Abstract: A needleless transseptal device assembly, and associated methods, for accessing the left atrium of a human heart includes a tubular body sized to navigate vasculature, and a dilator having a proximal end and a distal end. The dilator is substantially housed and axially movable within the tubular body. The assembly further includes a guidewire that is substantially housed and axially movable within the dilator. The guidewire includes a flexible proximal section and a flexible distal section, and the flexible distal section has a distal end with rotatable, septal tissue cutting elements. The distal end may be configured with a blunt shape. Further, the tubular body and the dilator may be arranged in a steerable configuration. A torquing member may also be coupled to the proximal section of the guidewire to assist in the rotational movement of the septal tissue cutting elements.

Abstract: A deflecting method and deflecting apparatus allows the distal end of device, for example an endoscopic medical device, to be remotely and adjustably deflected from a straight configuration to a deflected configuration. Manipulating a proximal handle causes the deflection, controls actuation of an end effector assembly on the distal end, and straightens the deflecting apparatus back to its original configuration.

Abstract: A device for extending, elongating, or repairing a previously created arteriovenous fistula between a first blood vessel and an adjacent second blood vessel includes a main body having a primary lumen and an articulating jaw member disposed at the distal end of the main body. The jaw member is configured with two elements to allow rotation of one element about a pivot point to grasp tissue while being rotated. The jaw member is also configured to allow thermal energy delivery to one or both elements of the jaw member that allow tissue welding and cutting with DC, RF, Laser or Ultrasonic energy. A second lumen located within one element of the jaw member is configured to allow advancement over a guidewire into the second vessel while the other element of the jaw member remains within the first blood vessel at the position where the arteriovenous fistula, or aperture, exists between the first and second blood vessel.

Abstract: A surgical instrument for use in releasing soft tissue within the human body. The surgical instrument has a handle with proximal and distal ends with a tube connected to the distal end. The surgical instrument also includes a blade member that slidingly engages the tube moving along the length of the tube to cut soft tissue. Further included in the surgical instrument is a guard member that is attached to the blade member. The guard member has a hood portion and a capture portion. The hood portion is connected to the blade member with the distally positioned capture portion acting to displace surrounding tissue while capturing certain soft tissue structures resulting in the blade member being in operative position to cut and release the soft tissue. A surgical instrument kit including a plurality of modular surgical instruments and method for releasing soft tissue using the surgical instrument are also disclosed.