Abstract: Apparatus and methods are described for use in securing a first bone relative to a second bone using a pair of surgical staples or, alternatively, a surgical staple and a bone screw. When a pair of staples are used, one of the legs of one of the staples may pass between the legs of the another of the staples. When a staple and a bone screw are used, the bone screw may pass between the legs of the staple. A guide tool can be used during the drilling of the holes for the legs of the staples or the legs of the staple and a bone screw. The guide tool provides guides for drilling guide holes for the staples or for the screw and staple. The guides can be fixed relative to each other during drilling of the guide holes.

Abstract: A port is provided for use with a wound dressing. The port has piercing means to change the configuration of wound dressing for use in a pressure gradient wound therapy apparatus or for use without a pressure gradient wound therapy apparatus. The port is for connecting a non-atmospheric pressure source to a wound dressing. It comprises a first aperture configured to connect to the non-atmospheric pressure source; and a wound dressing contact surface. The wound dressing contact surface includes a second aperture in fluid communication with the first aperture and configured to allow fluid communication with the wound dressing. The piercing means is configured to pierce the wound dressing as the wound dressing contact surface of the port is applied to the wound dressing.

Abstract: A surgical instrument (10) for scraping and collecting bone particles, comprising: a gripping handle (20); a blade (30) supported by the handle (20); and a collection chamber (40) of particles scraped by the blade (30), wherein the blade (30) comprises a plurality of cutting edges (320) separated from each other.

Abstract: Medical devices and methods for removing a predetermined portion of soft tissue from a target tissue layer, thereby creating a channel between two side walls of the target tissue layer, are described. The medical device is a cutting tool comprising: an elongated round body extending along a longitudinal axis and having a uniform outer cross-section at a proximal side thereof; a cutting portion at a distal side of the elongated body, comprising at a distal end thereof a cutting edge of a first cross-section being smaller than said outer cross-section, and a distally and continuously decreasing outer cross-section; and a chamber extending along the longitudinal axis inside the cutting tool from said cutting portion, the chamber having dimensions enabling storing of the removed soft tissue portion inside the chamber thereby providing a validation to the channel creation.

Abstract: An arthroscopic port introduction system includes an elongate hollow introducing needle and an elongate stylet sized and adapted to be disposed within the elongate hollow introducing needle together forming a single tissue-penetrating tip. The system also includes an elongate hollow enlarging shaft adapted to be disposed over the elongate hollow introducing needle. An operative tissue-penetrating length of the elongate hollow introducing needle is exposed beyond a distal end of the elongate hollow enlarging shaft. The elongate hollow introducing needle can be removed in a proximal direction from the elongate hollow enlarging shaft. An arthroscopic port sheath is disposed over the elongate hollow enlarging shaft and an operative tissue-penetrating length of the elongate hollow enlarging shaft is exposed beyond a distal end of the arthroscopic port sheath. The elongate hollow enlarging shaft can be removed in a proximal direction from the arthroscopic port sheath.

Abstract: A system for harvesting bone material from a bone may include a rotary cutter defining a rotary cutter longitudinal axis extending between a rotary cutter proximal end and a rotary cutter distal end. The rotary cutter may have a drive shaft configured to receive input torque, and an osteochondral cutter configured to cut the tissue and receive the tissue material in response to rotation of the osteochondral cutter under pressure against the tissue. The system may further include a bone port defining a bone port longitudinal axis extending between a bone port proximal end and a bone port distal end. The bone port may have a bone port cannulation sized to closely fit over the osteochondral cutter. At least one of the bone port proximal end and the bone port distal end may be securable to the tissue. A stratiform tissue graft may be delivered through the bone port.

Abstract: Medical devices and methods for removing a predetermined portion of soft tissue from a target tissue layer, thereby creating a channel between two side walls of the target tissue layer, are described. The medical device is a cutting tool comprising: an elongated round body extending along a longitudinal axis and having a uniform outer cross-section at a proximal side thereof; a cutting portion at a distal side of the elongated body, comprising at a distal end thereof a cutting edge of a first cross-section being smaller than said outer cross-section, and a distally and continuously decreasing outer cross-section; and a chamber extending along the longitudinal axis inside the cutting tool from said cutting portion, the chamber having dimensions enabling storing of the removed soft tissue portion inside the chamber thereby providing a validation to the channel creation.

Abstract: An anchoring system implantable in bone. The anchoring system includes a screw having a screw head, a screw shaft, a plurality of interface elements, each adjacent pair of the interface elements has an interface by-pass channel disposed therebetween, a boring ring that includes cutting teeth and a ring by-pass channel, and a coupling assembly that is adjustable with respect to a longitudinal axis of the screw.

Abstract: Methods and devices for consistently and accurately controlling the depth of the graft tunnel. A sheath is inserted into the bone until a stop member on the sheath contacts the bone. A cutting member is then deployed to drill a larger bore in the tunnel until making contact with the distal end of the sheath. The cutting member may be drawn retrograde within the tunnel, or driven antegrade from an opening opposite the opening in which the sheath resides. The drill and the sheath can then be removed, leaving the tunnel that includes a tunnel portion sized to fit a graft so that the graft fits tightly within the tunnel portion and is flush with the opening of the tunnel.

Abstract: A device (100) and method (1200) for autogenous bone grafting simultaneously cuts a cross-section of a bone (212), both longitudinally with a longitudinal cutting member (104), and transversely with a saw (140) during a bone drilling procedure to obtain a bone block (214) for repairing and rebuilding diseased bones. The device (100) is hand-controllable to selectively cut internally to the device (100), so as to cut captured bone (212) for internal bone harvesting. The device (100) also selectively cuts surrounding bone (212) outside the device (100) for external bone harvesting. The saw (140) is biased to stow in a wall space (120) when not in use, and rotate along a perpendicular plane (202) inwardly or outwardly for internal or external cutting of the bone (212), respectively. The saw (140) rotatably extends inwardly to support and carry the bone block (214) after a longitudinal section has been cut.

Abstract: A reamer used in orthopedic surgery that reams and collects bone cement. The reamer may come in different diameters and is used when removal of bone cement is necessary, as is commonly done in revision surgeries. The reamer has a cutting tip with a fluted opening connected to a hollow body in which the bone cement chips or shavings collect after passing through the tip. The other end of the reamer has a hub that can connect to a drill. As the reamer advances into the IM canal it shaves the bone cement off of the walls and/or the bottom of the intramedullary canal. The reamer has a central channel extending throughout its length through which a guide wire may be placed.

Abstract: A guided punch is disclosed. The guided punch generally comprises a strike cap comprising a strike surface, a punch comprising a distal cutting edge, and a guide rod. The strike cap defines a first cavity therein. The punch defines a second cavity therein in communication with the first cavity. The guide rod is located within the first and second cavities and extends a predetermined distance beyond the distal cutting edge of the punch. The strike cap and the punch are moveable relative to the guide rod.

Abstract: A clutch mechanism 5 for use with a carrier of a linear drive device 1, where the mechanism 5 includes: a housing 3; a first gear 6 coupled to the housing 3 and having gear teeth 61 configured to engage a threaded shaft 2 of a linear drive device 1, so that rotation of the shaft 2 causes the housing 3 to move along the shaft 2 in a first mode of operation; and a first clutch arrangement associated with the first gear 6 and configured to prevent substantial rotation of the first gear 6 with respect to the housing 3 when a rotational force applied to the first gear 6 is less than a threshold force and to permit rotation of the first gear 6 with respect to the housing 3 when a rotational force applied to the first gear 6 is greater than the threshold force.

Abstract: An intramedullary fixation assembly for bone fusion includes a first member positioned at a proximal end of the intramedullary fixation assembly, and a second member positioned at a distal end of the intramedullary fixation assembly. The first member is slideably coupled to the second member and provides for an interference fit with the second member. The intramedullary fixation assembly includes an optional cannulated threaded screw member having a plurality of threads on an external surface of the threaded screw member.

Abstract: A system for repairing cartilage includes a trephine having a passage extending along a longitudinal axis of the trephine. The trephine has a distal end and a proximal end. The distal end includes a cutting member operable to cut a cartilage plug from a donor site. The passage is operable to receive the cartilage plug. Also, the trephine is flexible to selectively move between a first position in which the longitudinal axis is substantially linear and a second position in which the longitudinal axis is nonlinear. Moreover, the system includes a guide tool that is removably coupled to the trephine. The guide tool is operable to selectively move the trephine between the first and second positions. In addition, the system includes an ejector tool that ejects the cartilage plug from the passage toward a defect site.

Abstract: The present disclosure relates to a surgical aimer including a shaft having a proximal portion and a distal portion and a handle coupled to the proximal portion of the shaft. The handle includes a mechanism for coupling the shaft to the handle and releasing the shaft from the handle.

Abstract: Medical devices for shearing tissue into small pieces are provided. One exemplary device includes oppositely rotating first and second rotatable members, each located at least partially within a distal housing. The device also includes first and second circular axle portions, and first and second blades that are directly adjacent to one another and positioned to partially overlap such that tissue may be sheared between the first and second blades, between the first blade and the second axle portion and between the second blade and the first axle portion. The rotatable members are configured to engage tissue from a target tissue site with teeth of the first and second blades, rotate towards one another and inwardly to direct tissue from the target tissue site through a tissue engaging opening and into an interior portion of the distal housing. Methods of fabricating and using the above device are also disclosed.

Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices include tissue anchoring projections, improved blade configurations, and/or shields or shrouds around the cutting blades to inhibit outflow of tissue that has been brought into the device.

Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices include tissue anchoring projections, improved blade configurations, and/or shields or shrouds around the cutting blades to inhibit outflow of tissue that has been brought into the device.

Abstract: Medical devices for shearing tissue into small pieces are provided. One exemplary device includes oppositely rotating first and second rotatable members, each located at least partially within a distal housing. The device also includes first and second circular axle portions, and first and second blades that are directly adjacent to one another and positioned to partially overlap such that tissue may be sheared between the first and second blades, between the first blade and the second axle portion and between the second blade and the first axle portion. The rotatable members are configured to engage tissue from a target tissue site with teeth of the first and second blades, rotate towards one another and inwardly to direct tissue from the target tissue site through a tissue engaging opening and into an interior portion of the distal housing. Methods of fabricating and using the above device are also disclosed.

Abstract: The invention relates to a tissue morcellator for minimally invasive surgery. The morcellator has a metallic cutting ring mounted on a visually transparent hollow cylinder, which in combination with a visually transparent outer morcellator tube enables a surgeon to visualize the inside of the morcellator shaft for detection of loose tissue fragments in the device. A tenaculum used with the morcellation device has a spacer for preventing contact with the blade. The cutting tube can oscillate, rather than rotate, along the longitudinal axis of the cutting tube. The morcellator utilizes an extendable tissue guide on the outer tube of the morcellator shaft for preventing the tissue from rotating along the longitudinal axis of the morcellator tube. This allows the tissue to be continuously rotated into the morcellator device for continuous peel. The tissue guide can also be fully retracted to allow for coring of the bulk tissue.

Abstract: An biopsy apparatus includes a pressure and vacuum generator including a first cylinder and a first piston movably disposed within the cylinder. The cylinder has a pressure generating region and a vacuum generating region. The biopsy apparatus also includes an outer cannula and an inner cannula having a lumen. The inner cannula is movably disposed within the outer cannula, and the vacuum generating region is in one-way fluid communication with the inner cannula lumen.

Abstract: A biopsy apparatus having a disposable cutting element and a reusable handpiece is disclosed. The disposable cutting element includes an inner cannula that defines an inner lumen and terminates in a cutting edge. The inner cannula is slidably disposed within an outer cannula that defines an outer lumen that has a tissue-receiving opening. The inner cannula is driven by a rotary motor and a reciprocating motor. Both motors are constructed of a MRI compatible material.

Abstract: A device and method of using the device to access a desired tissue site within a patient's body and separating a tissue specimen from the tissue site suitable for evaluation. The device includes a probe member having an arcuate tissue-cutting RF powered electrode secured to and distally spaced from the distal end of the probe and a small dimensioned distal extremity which when an inner lumen thereof is subjected to a vacuum, secured tissue for the specimen to the surface of the distal extremity. A circular tissue-cutting blade preferably secured to the distal end of a supporting tube is configured to rotate and move longitudinally along the shaft of the probe member effective to sever a tissue specimen from tissue secured to the surface of the distal extremity of the probe member. The supporting tube covers the separated specimen, and may be disposed within an accessing cannula.

Abstract: A system for repairing cartilage includes a trephine having a passage extending along a longitudinal axis of the trephine. The trephine has a distal end and a proximal end. The distal end includes a cutting member operable to cut a cartilage plug from a donor site. The passage is operable to receive the cartilage plug. Also, the trephine is flexible to selectively move between a first position in which the longitudinal axis is substantially linear and a second position in which the longitudinal axis is nonlinear. Moreover, the system includes a guide tool that is removably coupled to the trephine. The guide tool is operable to selectively move the trephine between the first and second positions. In addition, the system includes an ejector tool that ejects the cartilage plug from the passage toward a defect site.

Abstract: A system for transplanting a bone plug from a donor site to a recipient site extracts the bone plug from the donor site, and then places a bone plug delivery device having a tip which is at least translucent and, preferably, clear over a tube containing the bone plug. The tip is then placed substantially over a pre-formed hole in the recipient site, whereafter the bone plug is forced from the tube, through the transparent tip, and into the pre-formed hole.

Abstract: An improved tool for coring a portion of one or more hair follicles incorporates a mechanism that translates distal pushing forces that are applied to its handle to concomitant rotational movement of a hollow coring needle. Preferably, the force translation mechanism is realized by a helical threaded interface or a helical square rod interface between a handle and a rotating member that supports the needle. In another aspect, the tool includes a member that supports the hollow coring needle, the member having a cut-out that provides user access to the open proximal end of the needle. The tool can be made disposable by the use of injection molded plastic materials. The hollow coring needle is preferably realized from stainless steel and an anti-wear coating (such as a titanium nitride coating, a zirconium coating, or a diamond coating). In disposable applications, the tool is packaged in a sterilized manner, which avoids the need for the practitioner to sterilize the tool before use.

Abstract: A surgical kit is used for performing an anterior cervical disectomy, the surgical kit having a sheath that is inserted into a mammal by using a bullet coupled to the sheath and impacting on the bullet. Various cutters, including a cervical cutter having a drill tip end, a serrated cutter having an enclave for receiving cutting spoils therein, and a deburrment cutter having a burr end, are insertable through the sheath for cutting bone and disc matter. An impactor can be used to move the sheath within the mammal during use of the serrated cutter and deburrment cutter without the need to remove either tool. A pituitaries is used to remove loose bone and disc material.

Abstract: A biopsy apparatus having a disposable cutting element and a reusable handpiece is disclosed. The disposable cutting element includes an inner cannula that defines an inner lumen and terminates in a cutting edge. The inner cannula is slidably disposed within an outer cannula that defines an outer lumen that has a tissue-receiving opening. The inner cannula is driven by a rotary motor and a reciprocating motor. Both motors are constructed of a MRI compatible material.

Abstract: A polymeric, surgical clip having first and second curved legs joined at their proximal ends by a flexible hinge section and movable from an open position to a closed position for clamping a vessel between curved opposing inner surfaces. The first leg terminates at its distal end in a female locking member comprising a resilient inwardly turned hook having a recess in the mouth of the hook, and the second leg member terminates in a male locking member complimentary to the female locking member and comprising a detent such that when the first and second leg members are moved from an open position to a closed position about the hinge section the hook member will deflect about the distal end of the second leg member thereby engulfing the male locking member in the mouth of the hook and matingly engaging the detent in the recess thereof, thus securely locking the clip in the closed position. The locking feature provides greater closure security to the clip when clamping large diameter or uncompressible tissue.

Abstract: A medical punch includes a longitudinally dividable anvil with a reduced cross-sectional dimension facilitating insertion of the anvil into the vessel wall to achieve a clean aperture in the vessel wall by cooperative shearing action of a cutting edge and an anvil edge. In another embodiment, the instrument incorporates a measuring device for determining the thickness of a vessel wall between an anvil and a distal end of a cylindrical structure which together form a caliper, and the measuring device can also constitute a medical punch by cooperative shearing action of a cutting edge and an anvil to achieve a clean aperture in the vessel wall.

Abstract: A system for transplanting a bone plug from a donor site to a recipient site extracts the bone plug from the donor site, and then places a bone plug delivery device having a tip which is at least translucent and, preferably, clear over a tube containing the bone plug. The tip is then placed substantially over a pre-formed hole in the recipient site, whereafter the bone plug is forced from the tube, through the transparent tip, and into the pre-formed hole.

Abstract: A system for transplanting a bone plug from a donor site to a recipient site extracts the bone plug from the donor site, and then places a bone plug delivery device having a tip which is at least translucent and, preferably, clear over a tube containing the bone plug. The tip is then placed substantially over a pre-formed hole in the recipient site, whereafter the bone plug is forced from the tube, through the transparent tip, and into the pre-formed hole.

Abstract: The invention provides a method of and an apparatus for removing bone, capsule ligaments from a co-operating pair of superior and inferior articulating processes (also called facet joints) of the spine to create a path for postero-lateral endoscopic access to the vertebral foramen and to the epidural space of the spinal canal; successively advancing tools (64) of an increasing diameter along the path; advancing through a working cannula (40) of an endoscope in order to visualize the herniated disc material and to check for the presence of nerve roots or dural sac; and engaging soft tissue with a tool in the working cannula, the soft tissue deriving from the herniated disc, and withdrawing the tissue through the cannula, hereby to relieve pressure on nerve structures within the vertebral foramen and spinal canal.

Abstract: A catheter-based system for accessing specific body cavities percutaneously and minimizing patient trauma is provided. In the preferred embodiment, in order to create an aperture at an access site in a patient's existing tubular body organ structure, a delivery sheath is passed axially along the interior of a portion of the existing tubular body organ structure to place a distal end of the delivery sheath near the access site. A centering wire is passed axially along the interior of the delivery sheath, piercing through from inside to outside of the patient's existing tubular body organ structure at the access site by causing an end portion of the centering wire to emerge from the distal end of the delivery sheath. A cutting catheter is passed substantially coaxially over the centering wire and axially along the interior of the delivery sheath.

Abstract: A drill bit for cutting annular holes in medical casts without cutting into the covered skin surface. The drill bit includes, an elongated one-piece tubular body having a first end portion and a second end portion. The first end portion is closed except for a centered hole used to attach the drill bit to a driver. The second end portion incorporates a plurality of non-offset equilateral triangle shaped saw-like cutting surfaces machined into the circumference of the second end portion. When attached to a driver imparting a reciprocating motion, the drill bit responds with a self aligning bidirectional cut in the cast matrix obviating the need for a pilot bit. As a result, a cast core is safely cut without damage to the covered skin leaving a hole for aeration of the skin surface.

Abstract: A system and method for bracketing a tissue volume (22) and later locating the bracketed tissue volume. The system includes a plurality of markers (30) and a probe (32) and detector (34) for use in locating the markers by providing information usable by a surgeon that is representative of changes in proximity between the probe and the plurality of markers. The markers have various detection characteristics, e.g., they transmit gamma rays, that are detectable by an associated probe and detector. The tissue volume is removed by manipulating a cutting tool based on the proximity information provided by the detector which can be used by the surgeon to define the boundary of the tissue volume. A two-part cutting tool (200) is provided for removing the tissue volume, and a tissue anchor (300) is provided for stabilizing the tissue during removal. The system and method of the invention are particularly useful in bracketing and then removing a tissue volume from amorphous, pliable tissue such as breast tissue.

Abstract: Instrumentation for manufacturing a bone dowel from human or animal cadaveric bone and instrumentation for evaluating the suitability of the bone and/or dowel for implant use after each step of the manufacturing process is provided. Such instrumentation for manufacturing a bone dowel includes a blanking or coring apparatus, a milling apparatus, a threading apparatus and a tapping apparatus. A gauge is provided to inspect and determine the suitability of the bone dowel at each step of the manufacturing process. By inspecting the dowel being manufactured after each step of the manufacturing process, time and effort which is needlessly wasted during completion of the manufacturing of dowels which are unsuitable for implant use (due to unsuitable bone and/or inaccurate machining of bone) can be avoided. Instrumentation for more accurately positioning bone and the partially manufactured dowel into the instrumentation for machining the dowel is also provided.

Abstract: A system for transplanting a bone plug from a donor site to a recipient site extracts the bone plug from the donor site, and then places a bone plug delivery device having a tip which is at least translucent and, preferably, clear over a tube containing the bone plug. The tip is then placed substantially over a pre-formed hole in the recipient site, whereafter the bone plug is forced from the tube, through the transparent tip, and into the pre-formed hole.

Abstract: A system for transplanting a bone plug from a donor site to a recipient site extracts the bone plug from the donor site, and then places a bone plug delivery device having a tip which is at least translucent and, preferably, clear over a tube containing the bone plug. The tip is then placed substantially over a pre-formed hole in the recipient site, whereafter the bone plug is forced from the tube, through the transparent tip, and into the pre-formed hole.

Abstract: The present invention includes an apparatus and method for cutting a bone including a cutting assembly having a cutting blade, a cutting guide for guiding the shape of the cut in the bone, and a power source for powering the cutting blade. The cutting blade is moveable radially to vary the depth of the cut in the bone, and the cutting blade is capable of cutting around the circumference of the bone as well as in a longitudinal direction along the bone. A powered bone breaking device for completing the breaking of the weakened bone is also disclosed. A miniaturized version of the bone cutting apparatus can be used to cut out sections of a femur head from inside a femur body.

Abstract: A system and method for bracketing a tissue volume (22) and later locating the bracketed tissue volume. The system includes a plurality of markers (30) and a probe (32) and detector (34) for use in locating the markers by providing information usable by a surgeon that is representative of changes in proximity between the probe and the plurality of markers. The markers have various detection characteristics, e.g., they transmit gamma rays, that are detectable by an associated probe and detector. The tissue volume is removed by manipulating a cutting tool based on the proximity information provided by the detector which can be used by the surgeon to define the boundary of the tissue volume. A two-part cutting tool (200) is provided for removing the tissue volume, and a tissue anchor (300) is provided for stabilizing the tissue during removal. The system and method of the invention are particularly useful in bracketing and then removing a tissue volume from amorphous, pliable tissue such as breast tissue.

Abstract: A driven rotary incision scalpel having a pistol handle-shaped housing halves providing for mounting of a small form factor motor having a drive shaft. A gear on the front end of the drive shaft is enmeshed with the inner teeth of a ring gear of a two-stage reduction mount, which in turn drives a bevel gear that is enmeshed with a second driven bevel gear on a hollow rotary scalpel. When a trigger assembly is pulled backward and locked in, the outer barrel simultaneously moves to the rear, causing the front end of the hollow rotary scalpel to extend and switching on the motor that drives the blade at the front end into synchronous rotation.

Abstract: An apparatus and method using a laser in conjunction with a conventional tibial aiming device for assisting a surgeon in drilling collinear tibial and femoral tunnels during ACLR surgery. The laser is used to determine the angle at which to drill the tibial tunnel with respect to a femoral reference point selected by the surgeon so that the tunnels are collinear.

Abstract: A system and method for anterior fixation of the spine utilizes a cylindrical implant engaged in the intradiscal space at the cephalad and caudal ends of the construct. The implants are cylindrical fusion devices (10) filled with bone material to promote bone ingrowth and fusion of the disc space. An attachment member (40) is connected to each of the fusion devices (10) and a spinal rod (50) is connected to each of the attachment members using an eyebolt assembly (53, 54, 55). In a further inventive method, a revision of the construct is achieved by removing the fusion devices. Each fusion device is engaged by an elongated guide member (62) over which a cylindrical trephine (70) is advanced. The trephine (70) is used to extract a core (84) of bone material around the fusion implant, while the guide member (62) is used to remove the bone core (84) containing the fusion implant (10). In another aspect of the invention, a removal insert (90, 90') is provided that engages an implanted fusion device (10).

Abstract: A surgical instrument is provided for cutting a cranial disc from a skull cap. A cylindrical trepanning cutter is provided with teeth on its frontal edge. The teeth cut in both peripheral directions. A driving means drives the trepanning cutter with a periodically altering direction of rotation through an angle of rotation of substantially less than 360.degree.. The angle is at least large enough for the teeth to be displaced by one tooth spacing along the frontal edge of the cylindrical trepanning cutter.

Abstract: A drill guide assembly for producing a tunnel in a bone comprises a rack having a probe portion for engagement with a desired bony landmark, and a tool holder portion for holding tools for penetrating the bone. The probe portion is provided with an orifice therethrough. The tool holder portion is adapted to retain the tools for penetrating the bone, such that an extension of the axis of a tool passes through the orifice.

Abstract: A morcellator for removing large masses of tissues during laparoscopic procedures includes a rotationally fixed, axially movable inner tube disposed within a rotating cutting member. The cutting member is often disposed in the annular space between the inner tube and an outer tube. A laparoscopic grasping instrument is inserted through the lumen and draws the tissue proximally through the morcellator. As the cutting member severs tissue, the tissue is drawn into the fixed lumen of the inner tube. This prevents the cutting member from twisting the severed tissue, thereby preventing any degradation of the surgeon's control. A novel valve is provided to prevent loss of insufflation gas when no instrument traverses the lumen. The inner tube can be translated distally to protect tissues and/or other surgical implements against inadvertent contact with the cutting edge of the cutting member.

Abstract: A bone plug removal and emplacement tool includes a cylindrical cutting element having a proximal cutting edge and a cutting tooth. The outer surface of the cutting element can include an integral shoulder (e.g., in lieu of a replaceable outer sheath) that is spaced-apart from the proximal cutting edge and that engages the surface of the bone to define a depth stop for the cutting edge. An additional cylindrical element can be disposed within the cutting element. The proximal end of that additional element, which is referred to as a "harvester," is substantially aligned with the proximal end of the cutting element to receive a plug cut from the bone. The harvester can be slidably withdrawn from the cutting element to facilitate transplating the bone plug at another location. For this purpose, a stem or plunger can be slidably inserted and moved in the harvester to dislodge the plug.

Abstract: A system and method for anterior fixation of the spine utilizes a cylindrical implant engaged in the intradiscal space at the cephalad and caudal ends of the construct. The implants are cylindrical fusion devices (10) filled with bone material to promote bone ingrowth and fusion of the disc space. An attachment member (40) is connected to each of the fusion devices (10) and a spinal rod (50) is connected to each of the attachment members using an eyebolt assembly (53, 54, 55). In a further inventive method, a revision of the construct is achieved by removing the fusion devices. Each fusion device is engaged by an elongated guide member (62) over which a cylindrical trephine (70) is advanced. The trephine (70) is used to extract a core (84) of bone material around the fusion implant, while the guide member (62) is used to remove the bone core (84) containing the fusion implant (10). In another aspect of the invention, a removal insert (90, 90') is provided that engages an implanted fusion device (10).