Abstract: An improvement to a tissue removal device, that is, the addition of an adjustable protective guard and/or a retractable protective guard on the blade guard sheath of a mechanical tissue morcellator is presented. The retractable protective guard can be fixedly located at the distal end of a blade guard sheath and can be openly operated by a spring loaded means or a trigger means. The adjustable protective guard is moveably mounted in close contact around the blade sheath and may be positioned at any point along the length of the blade guard sheath in either direction. The addition of the adjustable protective guard and the retractable protective guard on the blade guard sheath of the mechanical tissue morcellator act to control and direct positioning of the tissue morcellator within the body cavity of the patient.

Abstract: An angled tissue cutting instrument comprises an angled outer tubular member rotatably receiving a flexible inner tubular member. The inner member has a flexible region in correspondence with an angle of the outer member. The flexible region comprises a helically cut length portion of an elongate tubular body of the inner member and a continuous solid flexible surface secured to an outer surface of the body along the helically cut length portion. A method of fabricating a flexible inner tubular member involves forming a helical cut through the solid wall of a length portion of a tubular body and securing a continuous solid flexible surface to the outer surface of the body along the helically cut length portion to form a flexible region.

Abstract: An piercing member is axially fixed to and positioned within a cutter, both of which are components of a stand-alone tool for creating an opening in the wall of a tubular tissue structure. The stand-alone tool includes an impulse source connected to the piercing member and to the cutter. An actuator is operationally connected to the impulse source, where the actuator causes the impulse source to release energy to and provide an impulse to the piercing member and the cutter. The tool may be configured to make multiple openings in the tissue of the same patient. Where the tool is configured to make multiple openings in the tissue of the same patient, the tool allows the piercing member and cutter to be moved back to an initial pre-deployment position after each use.

Abstract: A surgical morcellator includes a trocar body portion and a handle portion detachably mounted to the trocar body portion. The trocar body portion is relatively lightweight and may be used separately from the handle portion with other laparoscopic instruments while morcellation is not required during the surgical procedure.

Abstract: An anti-coring device for a surgical morcellator, which morcellator has a rotatable cutting blade having a sharpened edge and an outer sleeve that is axially moveable on the cutting blade, includes a shield mounted on the distal end of the outer sleeve and axially moveable therewith to selectively cover and at least partially uncover the sharpened edge of the rotatable cutting blade. The shield includes a main body and a protrusion extending axially from the main body and partially about the circumference of the cutting blade. The shield is axially positionable on the cutting blade so that is selectively covers the entire circumference of the sharpened edge of the cutting blade with its main body or only covers a portion of the circumference of the sharpened edge of the cutting blade with its protrusion, leaving the remaining portion of the sharpened edge exposed.

Abstract: Intravascular cutting device that does not require an inflatable balloon for blade deployment. A cutting wire can be reversibly moved between a retracted, non-cutting position in which the cutting wire does not contact tissue and an extended, cutting position in which the cutting wire does contact tissue.

Abstract: An apparatus includes a crushing part which rotates and crushes the calculus, wherein a radius of rotation of the crushing part with respect to a rotation axis thereof increases or decreases in accordance with a rotation speed of the crushing part.

Abstract: A system and method for performing skull based nasal, sinus and/or throat surgery. In the system and method of this invention a cutting accessory is applied to the tissue on which a procedure is to be performed. Simultaneously with the performance of the procedure by the cutting accessory, irrigating solution is discharged from the cutting accessory onto the tissue. The cutting accessory also has a conduit through which the discharged irrigating solution is drawn away from the surgical site. The irrigating solution discharged onto the surgical site facilitates the performance of the surgical procedure. This solution can also be used to remove debris from the distal end of an endoscope employed to view the procedure and/or as a transport media for topically applying medicine to the surgical site.

Abstract: The medical handpiece of the present invention includes a cutting tool having a flexible shank and a cutting bur, a plastically deformable tubular casing for the cutting tool, a handpiece body detachably holding the cutting tool, bearing members disposed in the casing, an inner intervening member for receiving the shank, and an outer intervening member arranged around the inner intervening member. The inner and outer intervening members are composed of a plurality of segments, and each segment is arranged between or on distal or proximal side of the bearing members. Each segment of the outer intervening member is further composed of a plurality of sub-segments. Annular members having the outer diameter that is larger than that of the outer intervening member are arranged between the sub-segments of the outer intervening member. The present handpiece provides improved operationality since shaking is hardly generated even when the casing is flexed.

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: An atherectomy burr has an operating diameter that is larger than the diameter of a catheter in which the burr is routed. The burr may include an expandable polymeric balloon having a partially abrasive exterior surface. The maximum expansion of the burr is controlled by an expansion mechanism. Various mechanisms are disclosed for controlling the maximum diameter of the burr thus preventing the burr from over expanding. In addition, the present invention includes systems that are pulled proximally to remove portions of a lesion located in a patient's vasculature. The system includes an ablation burr that has abrasive disposed on the proximal end. The burr may create a seal when expanded to block the ablated particulate so that an aspiration system can remove the particulate from the vasculature. Alternatively, the burr system may include a self expanding seal that is deployed out of the aspiration sheath.

Abstract: A surgical instrument, suitable for endoscopic surgery has a first member and a movably driven second member movable in such first member. One such member comprises a generally tubular proximal member and a tissue working tip which are relatively telescoped and have opposed surfaces. A projection protrudes from such tip surface through such generally tubular member surface to fixedly secure same together.

Abstract: An endoscopic morcellator device and method for use is provided. The morcellator device includes an elongate shaft having a proximal end and a distal end and a lumen extending therethrough, a handle coupled to the proximal end of the shaft, at least one active electrode disposed about a periphery of the distal end of the shaft, at least one return electrode disposed at the distal end of the shaft and electrically insulated from the at least one active electrode, and at least one fluid conduit extending along the shaft and having an outlet at the distal end of the shaft.

Abstract: A surgical cutting tool in which at least one slot is formed through the wall of a tubular housing and receives a blade. An actuator is disposed in the bore and engages the blade so that axial movement of the actuator in the bore causes radial movement of the blade relative to the slot to change the amount of tissue to be removed.

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 implement for use with a handpiece of a surgical instrument for performing a surgical treatment, comprises: an outer tube member including an outer hub and an outer tube extending longitudinally from the outer hub, the outer tube and the outer hub defining a longitudinal bore, the outer hub having a generally circular outer surface and including a circumferential locking groove and a key for releasable attachment of the outer tube member to the surgical instrument; and, an inner tube member including an inner hub and an inner tube extending longitudinally from the inner hub, the inner tube and the inner hub defining a longitudinal bore, the inner tube configured to insert within the longitudinal bore of the outer tube member and including an end effect portion disposed adjacent to a distal end of the inner tube, the inner hub having a generally circular outer surface and including a plurality of bosses radially formed on the outer surface thereof for releasably connecting the inner tube member to a

Abstract: Apparatuses and methods for removing solid tissue from beneath a tissue surface are described. The methods rely on positioning an energy conductive element at a target site beneath the tissue surface and energizing the element so that it can vaporize tissue. The element is then moved in a pattern which provides the desired tissue removal geometry, such as spherical, ovoid, or cylindrical. Usually, the shaft is moved, typically rotated or reciprocated, and the energy conductive element is moved relative to the shaft, typically by pivoting a rigid element or bowing a flexible element.

Abstract: A system and method is disclosed for making incisions in the sclera of an eye to form a scleral pocket to receive a scleral prosthesis. The system and method comprises a surgical tool comprising a surgical blade for making incisions in the sclera of an eye. When a surgeon places the surgical blade on the sclera of the eye a pressure sensor in the surgical tool determines whether there is sufficient pressure between the surgical tool and the sclera of the eye for the surgical tool to operate properly. The surgeon activates the surgical tool to cause the surgical blade to advance through the sclera to form an incision having dimensions to receive a scleral prosthesis. When the incision is complete the surgical blade is rotated back out of the incision. The incision has the exact dimensions to receive a scleral prosthesis.

Abstract: A high efficiency electrosurgical ablator which is subjected to a combined oscillatory and mechanical debridement motion during resection of tissue is disclosed. The electrosurgical ablator is positioned in the proximity of the tissue to be treated in the presence of an electrically conductive fluid. A high frequency voltage is applied to the electrode of the ablator, and the electrode is subjected to an oscillatory or other repetitive motion created by an element located within the ablator assembly. The ablator electrode is further connected to a suction assembly that supplies suction from an external source.

Abstract: One surgical device includes a first member and a second member defining a lumen for receiving the first member. The first member is configured to be movable relative to the second member to cut tissue. An electrical connector is physically and electrically coupled to the second member, to electrically couple the second member to a source of electricity. A tension device holds a distal region of the first member in electrical contact with a distal region of the second member. The first member includes a blade used both to cut tissue mechanically, and to coagulate cut tissue. The blade is electrically conductive and serves as an active electrode in a bipolar arrangement with a return electrode. Electrical energy is transferred to the blade through a point contact at a distal tip of the first and second members.

Abstract: An electro-cauterizing cannula assembly for use in a power-assisted liposuction instrument having a hand-holdable housing and a mechanism for reciprocating the cannula assembly. The electro-cauterizing cannula assembly includes an inner and an outer cannula, each having a distal and proximal end and at least one aspiration aperture about the distal end. The inner cannula is disposed within the outer cannula and the inner and outer aspiration apertures are in at least partial registration to form an effective aspiration aperture. During aspiration of tissue, high-voltage RF power signals are supplied to the inner and outer cannulas to effect hemostasis about the reciprocating aspiration aperture. Such hemostasis is achieved by causing protein molecules within aspirated tissue to coagulate in response to the high-voltage RF signals being supplied across the reciprocating cannulas. The cannula assembly is releasably detachable from the hand-holdable housing to facilitate cleaning and sterilization of the same.

Abstract: A percutaneous thrombolytic device, also referred to herein as a percutaneous mechanical fragmentation catheter system, that includes a wire cage or basket attached to a rotational drive motor. The fragmentation basket, ensheathed in an outer catheter, is introduced into the clotted graft or vessel via an introducer sheath. When deployed, the basket will automatically conform to the inner dimensions of the vessel lumen. The rotating basket is slowly withdrawn through the clotted graft, mechanically fragmenting the clot. The fragmented, homogenized debris can be flushed into the venous system or aspirated.

Abstract: An apparatus for abrading tissue includes a bearing tube having distal and proximal ends, and a suction port formed distally in a sidewall of the bearing tube. An inner tube disposed within the bearing tube has a distal opening, the distal opening being located proximal of the suction port in the sidewall of the bearing tube. A solid transition region extending distally from the inner tube is disposed distal to the distal opening. An abrading element supported distally by the solid transition region is used to perform orthopedic abrading procedures. The outer diameter of the abrading element is greater than the inner diameter of the bearing tube. Debris generated by abrading procedures is aspirated through the suction port formed in the sidewall of the bearing tube and into the lumen of the inner tube. A hooded sheath extends distally from the bearing tube, or optionally from a sheath tube provided over the bearing tube.

Abstract: A surgical tool system comprising a handpiece and a cutting accessory that is releaseably secured to the handpiece. The handpiece has a gear assembly with two drive heads. The gear assembly turns the drive heads at different rotational speeds relative to each other. The cutting accessory is provided with one of two drive hubs. If the cutting accessory is provided with a first drive hub, the drive hub mates to a first one of the drive heads so as to turn of the speed of that head. If the cutting accessory is provided with a second drive hub, the drive hub mates to the second drive head so as to turn at the speed of that head. Thus, the speed at which the cutting accessory is actuated is a function of the associated drive head.

Abstract: A percutaneous cellulite removal needle of the present invention can be used to make the appearance of cellulite less obvious by cutting the fibrous bridges that connect the skin to muscle/fascia or fibrous septae in the subcutaneous fat in a minimally invasive manner. The percutaneous cellulite removal needle of the present invention preferably includes a body having an internal chamber that ends at a laterally disposed aperture. A cutting mechanism is substantially positioned within the internal chamber in a retracted position and at least partially protrudes through the laterally disposed aperture in a cutting position. A situating mechanism transitions the cutting mechanism between the retracted position and the cutting position. The present invention also includes a method in which the percutaneous cellulite removal needle is inserted through the skin with the cutting mechanism in the retracted position. The cutting mechanism is then extruded so that the cutting mechanism is in the cutting position.

Abstract: A biopsy device suitable for collecting cells from a mammary duct is provided. The device is suitable for conducting brushing biopsy and tissue excision procedures. The device comprises a sheath that is rotatable about a longitudinal axis. The device further comprises an endoscope disposed within and extending through the sheath. An adjustment mechanism is also operatively connected to the endoscope to longitudinally extend and retract the endoscope within the sheath.

Abstract: A system is disclosed for creating a hole in a body vessel or hollow organ. Such holes are useful in surgically preparing the hollow organ or body vessel for connection with another hollow organ, body vessel or prosthetic conduit. For example, an assist device is generally connected to the left ventricle through a ventriculotomy created at the apex of the left ventricle. This ventriculotomy is most easily created with a punch or trephine. Control over such a procedure must be precise so as not to damage the ventricular wall or intracardiac structures such as papillary muscles, chordae tendinae, etc. The punch of the current invention allows for precise location and alignment of the cutting segment. The punch of the current invention also allows for precise advance of the cutting blade and a very clean cut of the tissue. Such clean cuts improve the healing when the hole in the body vessel or hollow organ is closed or attached to a connection, either prosthetic or natural.

Abstract: A rotational angioplasty device having a handle housing and an exchangeable drive shaft cartridge. The handle housing includes a rotatable prime mover carried by a prime mover carriage which is longitudinally movable with respect to the handle housing. The exchangeable drive shaft cartridge includes a tubular core element, a longitudinally extendible tube, a catheter and a rotatable drive shaft which, near its distal end, has an abrasive tissue removal implement. The cartridge is detachable from the handle housing, the longitudinally extendible tube is detachable from the prime mover carriage, and the drive shaft together with its tissue removal implement may be attached to and detached from the prime mover, thereby permitting the exchangeable drive shaft cartridge to be selectively attached to and detached from the handle housing.

Abstract: A method for preparing and cutting the radial and carpal bones to receive a prosthetic wrist during a total wrist arthroplasty. Cuts on both the radius and carpal bones are made from a single broach. The broach is embedded in the intramedullary canal of the radius and a cutting tool is attached to an end of the broach to resect the radius. With the cutting tool removed, a cut block is attached to the broach and the carpal bones are resected. The cut block has a thickness that equal the thickness of the bearing component of the wrist prosthesis.

Abstract: A percutaneous thrombolytic device, also referred to herein as a percutaneous mechanical fragmentation catheter system, that includes a wire cage or basket attached to a rotational drive motor. The fragmentation basket, ensheathed in an outer catheter, is introduced into the clotted graft or vessel via an introducer sheath. When deployed, the basket will automatically conform to the inner dimensions of the vessel lumen. The rotating basket is slowly withdrawn through the clotted graft, mechanically fragmenting the clot. The fragmented, homogenized debris can be flushed into the venous system or aspirated.

Abstract: A portable and disposable device is provided for processing harvested dermal tissue. The device includes a housing presenting a handle having a gripping surface and a cutting head attached to the handle. A cutting assembly is supported by the cutting head and includes a plurality of spaced cutting blades that are rotatable with respect to the housing. A receptacle is disposed downstream of the cutting assembly and receives the sliced tissue from the cutting blades. The device is thus operable to slice harvested tissue into strips, and further into fine particles, that can be used for transplantation onto a wound site.

Abstract: The intralumenal material removal system includes a cutter assembly positionable in the lumen of a mammalian subject and operably connected to system controls. The cutter assembly is axially advanceable by translating the drive shaft and rotatable by rotating the drive shaft. One cutter assembly comprises an adjustable cutter that is adjustable between a smaller diameter condition and a larger diameter condition by rotation of the drive shaft in opposite directions. The cutter may thus be introduced to and withdrawn from the material removal site in a retracted, smaller diameter condition that facilitates translation and navigation of the device through various lumens. The adjustable cutting assembly may be selectively expanded at the material removal site to facilitate cutting, removal and aspiration of the occlusive material. One composite cutter assembly comprises both a distal, fixed diameter cutter and a proximal adjustable diameter cutter.

Abstract: A surgical instrument and method for forming a passage in bone having an enlarged cross-sectional portion is provided. The instrument includes an elongate member and a cutting element engaged thereto and transitionable between a retracted configuration for extending through a first portion of the passage and an expanded configuration for forming a second portion of the passage having an enlarged cross-section. In one embodiment, the cutting element is transitioned between the retracted and expanded configurations by axially displacing the cutting element relative to the elongate member. In another embodiment, the elongate member includes a tapping thread configured to cut threads along the first portion of the passage, and the cutting element is a blade configured to form the enlarged cross-section when transitioned to the expanded configuration.

Abstract: A system for removing matter from a partially or totally occluded stent includes a cutter that is urged radially outward toward the inner surface of the stent. Preferably, the cutter has a hardness that is less than or equal to the hardness of the material used to make the stent. Aspiration may be provided to remove portions of the occluding material from the vessel.

Abstract: A rotational ablation atherectomy device including a flexible drive shaft and a compressible burr that may be inserted and extracted from a patient using a catheter having a diameter that is smaller than the operational diameter of the burr. In one embodiment, the burr includes a nose portion coupled to the drive shaft and one or more flexible abrasive disks disposed rearwardly from the nose portion. The flexible disks are foldable to be slidably received within a catheter. In another embodiment, the burr includes a support member coupled to the drive shaft, the support member having a resilient panel that spirals outwardly, forming a generally cylindrical ablation surface. The flexible panel can be elastically urged toward the support member and slidably inserted into the catheter. In a third embodiment, the burr includes a plurality of struts that are coupled to the drive shaft. An elastically compressible body disposed between the struts permits the struts to flex inwardly to reduce the burr diameter.

Abstract: One or more curved axial bore is formed commencing from an anterior or posterior sacral target point and cephalad through vertebral bodies in general alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation/fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment. Generally curved anterior or posterior TASIF axial bores are formed in axial or parallel or diverging alignment with the visualized AAIFL or PAIFL, respectively. The anterior and posterior TASIF axial bore forming tools can be manipulated from proximal portions thereof to adjust the curvature of the anterior or posterior TASIF axial bores as they are formed in the cephalad direction.

Abstract: A tissue processing system includes a series of blades arranged in parallel to form a tissue processor. The blades may be adjusted to create a spaced between each blade in the range of 250-1000 microns. A slicer is included to remove a donor tissue to be processed by the processor. The processor is rotatable 90 degrees so as to create uniform micrografts of tissue for transplanting to a recipient site. An extractor is included to remove tissue particles from the processor after they have been cut into an appropriate size. A cutting block may be provided to ensure uniform thickness of cuts of the donor tissue.

Abstract: A method and apparatus is disclosed for mechanically-assisted liposuction treatment. The apparatus includes a hand-holdable housing, an electro-cauterizing cannula assembly, and a reciprocation mechanism. The hand-holdable housing has a cavity adaptable for receipt of a portion of the electro-cauterizing cannula assembly. The electro-cauterizing cannula assembly includes an inner cannula and an outer cannula, each having a distal end and a proximal end and at least one aspiration aperture about the distal end. The inner cannula is disposed within the outer cannula and the inner and outer aspiration apertures are in at least partial registration to form an effective aspiration aperture. The reciprocation mechanism is disposed within the housing and is operably associated with either the inner or outer cannula so that one of the cannulas can be selectively caused to reciprocate relative to the housing while the other is stationarily disposed relative to the housing.

Abstract: The invention is an oscillating, high speed burring instrument comprised of a handpiece, an elongate arthroscopic catheter extending distally from handpiece and terminating in a flexible or hinged portion which itself terminates with an oscillating burr. At least the distal portion of torsional drive shaft is radially flexible to accommodate the flexibility of the flexible or hinged portion of the catheter. A high speed oscillation of the burr is employed effective for cutting or abrading bone, which is typically oscillated at 10 kHz or higher. The burr is oscillated over a substantial arc, namely a majority portion of a full circle. The burr is not shielded in any manner and is fully exposed to the operational theater. The burr cuts or abrades bone or hard matter, while leaving softer tissues substantially or entirely undamaged.

Abstract: What is described here is a device for ablation of an aortic valve on the human heart by a minimally invasive surgical operation, comprising a centering and fixing body adapted to be introduced inside the aorta, which can be fixed relative to the aorta via at least one holding means, a drive shaft projecting centrally through said centering and fixing body, at least in part, and presenting a distal end, a cutting device fixedly mounted for rotation on the drive shaft in the region of the distal end of the drive shaft, as well as an aspiration device provided on the proximal side, relative to said cutting means, on said centering and fixing body.

Abstract: A surgical instrument for the dissection of bone and other tissue includes a spindle, a dissection tool and an coupler disposed between the spindle and the dissection tool. The coupler includes a tool collet and an attachment locking mechanism operable to permit tool collet operation and telescoping movement of an attachment tube with respect to the dissection tool. A method is also provided for convenient coupling of the dissection tool and adjustment of the attachment tube length.

Abstract: A percutaneous surgical device and method for creating a cavity within tissue during a minimally invasive procedure. A cavitation device includes a shaft interconnected to a flexible cutting element. A flexible cutting element has a first shape suitable for minimally invasive passage into tissue. The flexible cutting element has a means to move toward a second shape suitable for forming a cavity in tissue. When used in bone, the resulting cavity is usually filled with bone cement or suitable bone replacement material that is injectable and hardens in situ. The disclosed cavitation device and methods can be used for the following applications: (1) treatment or prevention of bone fracture, (2) joint fusion, (3) implant fixation, (4) tissue harvesting (especially bone), (5) removal of diseased tissue (hard or soft tissue), and (6) general tissue removal (hard or soft tissue).

Abstract: An apparatus and method for minimally invasive surgery using a cutting tool with rotational cutting edges. The surgical instrument includes a tube having a distal end and a cutting edge at the distal end. A handle is attached to the proximal end of the tube. Within the tube is a shaft having a longitudinally extending blade at its distal end that is adjacent to the distal end of the tube. The blade is revolvable about the longitudinal axis of the instrument to provide rotational cutting action. One or both of the blade and the cutting edge on the tube can be electrically energized to provide for electrocauterization of the body tissue being cut.

Abstract: One or more shaped axial bore extending from an accessed posterior or anterior target point are formed in the cephalad direction through vertebral bodies and intervening discs, if present, in general alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation/fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment.

Abstract: Methods and devices for treating diseases and conditions that change the spacial relationship between the vertebral bodies and the intervertebral disks, or that cause instability of the vertebral column, or both, and a method and devices that allow the surgeon to access the intervertebral space to restore a more normal three-dimensional configuration of the space, with or without additionally fusing two adjacent vertebrae.

Abstract: A disposable battery powered rotary tissue cutting instrument for soft tissue removal includes a blade attached to a powered surgical handpiece. The blade comprises an elongate tubular outer member and an inner member rotatably disposed within the outer member to cut anatomical tissue. The handpiece contains a motor having a drive shaft coupled in driving engagement with the inner member and a battery unit for supplying electric current to rotate the drive shaft to effect rotation of the inner member within the outer member. The inner member is continuously rotated in one direction or is continuously oscillatorily rotated in forward and reverse directions. The instrument is disposable after single patient use and may include a use-limiting unit for automatically disabling the instrument to prevent its reuse after completion of a surgical procedure performed using the instrument on a single patient. The blade may be used for electric cautery.

Abstract: A magnetically navigable atherectomy device includes a cutting head, a flexible drive shaft having a proximal and a distal end, with the cutting device on the distal end, and a magnet associated with the cutting head, the magnet of sufficient size to allow the cutting head to be oriented by an externally applied magnetic field. The magnet may be a portion of the cutting head made from a magnetically permeable or permanent magnetic material, a portion of the drive shaft made from a magnetically permeable or permanent magnetic material; a separate magnet between the cutting head and the drive shaft, a portion a magnet on a sheath covering the drive shaft. Alternatively a guide wire can provided with a magnetic material on its distal end. Through the application of a magnetic field and/or a magnetic gradient, the artherectomy device can be guided to the location of the atheromatous material in the body.

Abstract: The present invention is directed to a fiber, preferably bone fiber, having a textured surface, which acts as an effective binding substrate for bone-forming cells and for the induction or promotion of new bone growth by bone-forming cells, which bind to the fiber. Methods of using the bone fibers to induce or promote new bone growth and bone material compositions comprising the bone fibers are also described. The invention further relates to a substrate cutter device and cutter, which are effective in producing substrate fibers, such as bone fibers.

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 surgical instrument includes a tubular stem section which extends from a handle. A tubular articulated section connects a surgical instrument with the stem section. An actuator assembly is connected with the handle and is operable to bend the articulated section to change the orientation of an instrument on an outer end portion of the articulated section relative to body tissue. The instrument on the outer end of the articulated section may be a rotatable cutting tool which is driven by a tubular drive element having a flexible section which extends through the articulated section. The articulated section is bent or flexed by a plurality of flexible elongated elements (wires). In one embodiment of the invention, a pair of elongated elements are provided to flex the articulated section in opposite directions. In another embodiment of the invention, four flexible elongated elements are provided to flex the articulated section in any one of four directions.