Abstract: The invention is directed to a bladeless trocar and obturator combination configured to separate body tissue. In one aspect, the obturator of the invention includes a rigid shaft extending along an axis between a proximal end and a closed, tapered distal end. The bladeless, closed and tapered tip is adapted to penetrate tissue. The shaft is sized and configured to receive an optical instrument having a distal end to receive an image of the body tissue. The shaft includes an ledge on the inner surface to provide proper positioning of the distal end of the optical instrument. The tapered configuration facilitates separation of different layers of the body tissue and provides proper alignment of the tip between the layers.

Abstract: Methods and devices described herein facilitate improved access of locations within the body by providing a variety of dissection modes on a single access device.

Abstract: A device for inserting a tracheal tube into a tracheostomy has as insertion aid with a shaft (6, 6?, 14) which can be inserted through the tracheal tube, and a conical tip (2, 13) which is or can be joined to the tracheal tube. In order to provide a device for inserting a tracheal tube which considerably reduces the risk of injury when inserting the tracheal tube, which makes the insertion process easier, the inserted tube being highly comfortable even with a long-term use, keeping low the danger of injuries or sore points in the trachea, the insertion aid according to the invention has a conical tip (2, 13) which can have a small base diameter in a first state and a large base diameter in a second state.

Abstract: In endoscopic surgery, a retractor having independently spreadable retractor blades mounted at the distal end of a tube is introduced percutaneously. A balloon dissector is passed through the tube and expanded. Following dissection by expansion of the balloon, the balloon is contracted, the tube is advanced, and the dissected tissue is spread by moving the blades apart from each other. The balloon dissector is withdrawn and another instrument is then introduced to carry out surgery on the anatomical structure exposed by the dissection and spreading steps.

Abstract: A supply device for a surgical apparatus for operating a surgical instrument that includes a control unit for controlling the surgical instrument, a memory unit for storing configuration data, and a mediating unit for allocating an adjustment value to a mathematical function to obtain a scaling factor, and methods of using such a supply device.

Abstract: An implant for placement within a hollow body organ. The implant has a member with distal and proximal ends. The member has an undeployed shape for delivery to the hollow body and a deployed shape for implantation therein. The implant has at least one tensioning tether with a first end attached to at least one of the distal and proximal end and a second ends attached to the member between the distal and proximal ends. Wherein applying tension to the tether moves the member towards the deployed shape. The member preferably has a first rate at which it initially resists bending, and a second substantially higher rate at which it resists further bending.

Abstract: Systems, devices, and methods for removing plaque from a patient's vasculature. In one example, a medical article includes a catheter body and a dissection tip. The dissection tip can move between at least a first position and a second position and can be biased to expand radially from a longitudinal axis of the medical article when the dissection tip is moved from the first position to the second position. In one example, a dissection member includes a dissection tip and a receiving space. The dissection tip can radially adjust to circumferentially maneuver between a core of plaque and a patient's vasculature. The receiving space can receive at least a portion of a core of plaque that passes through the dissection tip.

Abstract: A supply device for the operation of at least one medical instrument, in particular an electrosurgical instrument and/or a cryosurgical instrument and/or a water jet surgical instrument. The supply device includes a control unit for the control of the at least one medical instrument and a memory unit for the storage of configuration data which describe a state device with a plurality of states. The control unit is designed such that it reads in configuration data and converts the state device into a control program and controls the at least one medical instrument according to the control program. This ensures efficient control of medical instruments because the control programs used can be more efficiently checked for their correctness and updated accordingly.

Abstract: An apparatus is disclosed for removing tissue from a patient's body. The apparatus comprises a first elongate member defining a lumen and having an open distal end. The open distal end defines an opening and comprises a tip, where the tip is structured to reduce damage to tissue within the patient's body. The apparatus further comprises a tissue removal member disposed within the lumen of the elongate member. The tissue removal member comprises a distal end that is recessed from the tip of the elongate member. At least a portion of the tissue removal member protrudes beyond the opening to allow access to tissue distal to the opening. Related hollow members with blunt tips are also disclosed.

Abstract: An obturator assembly for penetrating tissue and being at least partially positionable within a cannula assembly includes an obturator housing, an obturator shaft connected to the obturator housing and defining a longitudinal axis, a bladeless penetrating member adjacent the distal end of the obturator shaft and an obturator shield mounted about the obturator shaft and having a distal shield nose. The obturator shield is adapted for longitudinal movement between an extended position where the bladeless penetration member is substantially enclosed within the shield nose and a retracted position where the bladeless penetrating member is at least partially exposed from the shield nose.

Abstract: A surgical obturator comprising an elongate shaft extending along an axis between a proximal end and a distal end includes a bladeless tip disposed at the distal end of the shaft. The tip has a blunt point and a pair of shorter side surfaces separated by a relatively longer pair of opposing surfaces to form in radial cross-section a geometric shape that has a longer length and relatively narrower width. The side surfaces and opposing surfaces terminate in end surfaces located proximally from the blunt point. The end surfaces extend radially outwardly from opposite locations of the outer surface. A conical surface facilitates initial insertion of the obturator and the geometric shape facilitates separation of consecutive layers of muscle tissue having fibers oriented in different directions and provides proper alignment of the tip between the layers of muscle.

Abstract: Systems, devices, apparatus and methods that may be used for en bloc circumferential esophageal mucosal resection or ablation that can extend over only a selected portion or all of the length of the esophagus.

Abstract: A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

Abstract: A fluid conditioning system is adapted to condition the fluid used in medical and dental cutting, irrigating, evacuating, cleaning, and drilling operations. The fluid may be conditioned by adding flavors, antiseptics and/or tooth whitening agents such as peroxide, medications, and pigments. In addition to the direct benefits obtained from introduction of these agents, the laser cutting properties may be varied from the selective introduction of the various agents.

Abstract: An apparatus for creating an anatomic space in tissue in a body comprises an introducer and a sheath. The tubular sheath may surround the introducer, and may have a weakened region along its longitudinal axis. A handle may be provided on the sheath. The handle may be adapted to be pulled proximally to separate the weakened region and allow the sheath to be removed from the introducer. The sheath may be secured to the introducer via detents or latches on the handle.

Abstract: Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs.

Abstract: A surgical probe includes an articulated digit located at a distal end of a positioning shaft having a longitudinal axis. An actuator is located at a proximal end of the positioning shaft that is operatively connected to the articulated digit so as to move it between a continuous range of positions from an extended position to a substantially curved position while maintaining a kinesthetic relationship between a surgeon's finger engaging the actuator and the articulated digit. Preferably, the surgeons finger position and shape directly correspond to the position and shape of the articulated digit. A method is provided for probing, dissecting, and retracting anatomical structures.

Abstract: Apparatus for creating an anatomic space in tissue in a body including an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A blunt tip is secured to the distal extremity of the tunneling shaft. A balloon assembly is provided. The balloon assembly is removably secured to the tunneling shaft. The balloon assembly includes a deflated collapsed balloon. A sheath encloses the balloon and is carried by the tunneling shaft. The sheath has a weakened region extending longitudinally thereof permitting the sheath to be removed to release the balloon.

Abstract: A handheld medical instrument designed for efficient, atraumatic blunt tissue dissection and/or elevation during surgery. The instrument generally comprises an elongated shaft having a cottonoid or similar disposable dissection device at one or both ends. Attachment to the cottonoid may be direct or the shaft may include grasping constructs designed to grasp the cottonoid or to grasp a support structure which is attached to the dissection device. The devices may have reusable components or may be disposable.

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layer to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creature of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdrawn through the incision.

Abstract: A surgical obturator is disclosed comprising an elongate shaft extending along an axis between a proximal end and a distal end, and a bladeless tip disposed at the distal end of the shaft. The bladeless tip has a conical surface forming proximally into an outer surface, the outer surface extending distally to a blunt point and having a pair of side sections. The side sections extend from the blunt point radially outwardly with progressive positions proximally along the axis. The conical surface facilitates insertion of the obturator with a reduced penetration force and minimizes tenting of the body wall. The conical surface further facilitates separation of different layers of the body wall and provides proper alignment of the tip between the layers.

Abstract: A tunneling device for creating a pathway in subcutaneous tissue of a person's body. The tunneling device includes a member having two ends, where each of the ends defines an insertion surface that facilitates the insertion of the ends into the subcutaneous tissue of the person's body. The tunneling device includes an interchangeable handle connectable to each of the ends. The handle defines a grasping surface and an opening. The opening is configured to receive either of the ends. The grasping surface enables a user to securely hold the handle with one hand to forcibly move the member through the subcutaneous tissue of the person's body to create the pathway in the subcutaneous tissue, and pull a cable of an implant device through the created pathway.

Abstract: Methods and devices for performing intravascular endarterectomy. Methods includes intravascularly advancing a catheter having a carbon dioxide delivering distal end past a plaque-occluded vessel site, passing the distal end between the plaque and vessel wall. Other methods include intravascularly advancing paddles between plaque and vessel walls, including ultrasonic imaging paddles, ultrasonic vibrating paddles, and mechanically vibrating paddles. Some methods include providing intravascular devices having radially expandable jaws or paddles, and advancing those jaws or paddles along vessel walls to separate plaque from vessel walls. Still other methods include providing an anchoring guide catheter adapted to establish a suction grip around the left coronary artery ostium, and to use the anchored guide catheter to support intravascularly introduced endarterectomy devices operating on plaque in the left main coronary artery.

Abstract: A surgical obturator that includes an elongated shaft defining a longitudinal axis and an obturator member disposed adjacent a distal end of the elongated shaft. The obturator member may include a proximal section being convex along a majority of its length. It may also include a central section disposed adjacent the proximal section, the central section including a first pair of surfaces disposed relative to each other on radially opposite sides of the central section, and a second set of surfaces disposed between the first pair of surfaces and further being disposed relative to each other on radially opposite sides of the central section, at least a portion of a length of each one of the first pair of surfaces being concave, and at least a portion of a length of each one of the second pair of surfaces being convex. The obturator member may also include a guiding nub disposed distally of the central section and including a rounded distal-most portion.

Abstract: Methods and devices for harvesting veins from the body. The methods and devices allow vein harvesting using laparoscopic procedures. A working space is created over the vein using standard laparoscopic procedures and a side-hooked wire is inserted into the working space and twisted to insert the side-hook under the vein. The wire is then pulled or drawn along the vein to separate the vein from the surrounding tissue. In an alternative embodiment, vein separation is accomplished by threading a soft rubber tube under the vein, grasping the ends of the tube so as to surround the vein, and then pulling the tube along the vein. In other embodiments, the working space is created with everting balloons.

Abstract: Venous dissector device, notably a seamless device (1), preferably made in polymer, comprising a ergonomic rod (2), followed by a central region (3) substantially elliptical, with grooves (4) for a better handling, and a tip (5) with end hook (6), responsible for exposing the sick vein.

Abstract: A medical expanding apparatus is disclosed that can separate adhered neural tissues or muscle tissues. The apparatus includes an expanding member, an air tube, a connecting part, a body, and a front cover. The expanding member is expanded in the human body using air pressure. The air tube, whose one end is coupled to the expanding member, holds the expanding member and guides the air into the inside of the expanding member. The connecting part, whose one end is fitted into the other end of the air tube to be tightly coupled to the air tube, guides the air into the air tube. The body has an air inflow pipe and transfers the air flowing in through the air inflow pipe to the connecting part in order to expand the expanding member. One end of the body is coupled to the other side end of the connecting part. The front cover, coupled to the one end of the body, closely couples the connecting part and the body, so that the body holds the connecting part.

Abstract: Described herein is one or more implementations for a percutaneous spinal registration-and-access tool for minimally invasive spinal surgery involving lumbar pedicle screw fixation and registration (which is the set-up process for spinal computer navigation). This spinal registration-and-access tool aids registration by allowing more precise targeting of the spinous process (of the vertebrae) and safe working channel for percutaneous placement of a sharp tool (e.g., a bone pin) through the protected subcutaneous tissue.

Abstract: A bone fusion system and method is disclosed. The system includes a bone mill having at least one docking station that is located at a position other than where a user inserts bone to be morcellated into the bone mill. This allows, for example, a surgeon to deposit morcellated bone onto a desired location on a patient's spine immediately after the bone is morcellated. The bone mill can include two or more docking stations having different sizes so that a surgeon can couple differently sized syringes to the bone mill. This allows, for example, morcellated bone to be deposited at two or more locations immediately after the bone is morcellated. A hand held retractor having a serrated tip is included so that a surgeon can simultaneously retract a patient's muscle bundles while decorticating a recipient bed.

Abstract: A method comprising removing a port from a patient through an incision and coupling a rod disposed in a sheath to the end of a catheter. The method also includes sliding the sheath along the rod and catheter into tissue surrounding the catheter in a rotating manner to separate the tissue from the catheter until the catheter is able to freely be removed from the patient, and removing the catheter from the patient. The method may also include making a shorter second incision on the patient and exposing a portion of the catheter through the patient's skin to facilitate coupling of the rod with the catheter and retrieval of the catheter.

Abstract: Devices and methods for moving tissue and/or moving the devices relative to the tissue during a surgical procedure are disclosed. The devices and methods disclosed herein can be used in conventional, open surgical procedures, they are particularly useful in minimally invasive surgical procedures, such as laparoscopic and endoscopic procedures. In one aspect, the movement or tissue and/or the device is effected by moving a fabric associated with the device and in contact with tissue.

Abstract: According to one aspect of the present invention, there is disclosed a treatment sheath for endoscopic blood vessel harvesting, comprising a sheath main unit which can be inserted into a body through a cut skin portion in order to harvest a blood vessel in the body, a channel which is formed along a longitudinal direction in the sheath main unit and through which an endoscope is inserted so as to be insertable/detachable, a blood vessel holding member which is disposed at the sheath main unit and which holds the blood vessel to be harvested; and a blood vessel cutting device which is disposed at the sheath main unit and is positioned substantially symmetrically with the blood vessel holding member with respect to the channel and which cuts the blood vessel to be harvested.

Abstract: Implantable medical endoprosthesis delivery systems and articles are provided.

Abstract: A tunneling device for creating a pathway in subcutaneous tissue of a person's body. The tunneling device includes a member having two ends, where each of the ends defines an insertion surface that facilitates the insertion of the ends into the subcutaneous tissue of the person's body. The tunneling device includes an interchangeable handle connectable to each of the ends. The handle defines a grasping surface and an opening. The opening is configured to receive either of the ends. The grasping surface enables a user to securely hold the handle with one hand to forcibly move the member through the subcutaneous tissue of the person's body to create the pathway in the subcutaneous tissue, and pull a cable of an implant device through the created pathway.

Abstract: A system for tissue dissection and retraction is disclosed herein. A tissue dissection assembly generally comprises an elongate body shaft, an actuation member movable relative to the elongate body shaft, and at least one dissector arm member having at least a first end attached to the elongate body shaft, wherein the at least one dissector arm member is adapted to reconfigure within a plane from a low profile to an expanded profile when urged via the actuation member, and wherein the at least one dissector arm is further adapted to dissect tissue within the plane. In use, the assembly dissects tissue within the plane typically by advancing the elongate body shaft into the tissue region where the dissector arm member or members are then reconfigured within the plane from its low profile to its expanded profile to thereby dissect the tissue region along the plane.

Abstract: The present invention provides balloon dissection apparatus and methods of use in which an elongate balloon is utilized to dissect along a region that follows a naturally existing path alongside a vessel or structure, such as an artery, a vein, a lymphatic vessel, the trachea, the esophagus, or even a nerve bundle.

Abstract: Instruments, systems, implants, and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, and a mucosal resection device. A submucosal implant device for diagnosing and treating disorders of the body may be implanted. A passive submucosal implant device may take the form of a drug delivery depot in which a therapeutic agent within the depot elutes from the depot according to a predetermined elution profile. An active submucosal implant device may take the form of a drug delivery device that incorporates a self-contained diagnostic system to determine the appropriate delivery time and dosage of a therapeutic agent to be administered.

Abstract: The present invention provides balloon dissection apparatus and methods of use in which an elongate balloon is utilized to dissect along a region that follows a naturally existing path alongside a vessel or structure, such as an artery, a vein, a lymphatic vessel, the trachea, the esophagus, or even a nerve bundle.

Abstract: An improved tunneling instrument for use in breast augmentation, having a distal end and a proximal end; includes a two piece system comprising of a penetrating bullet tip permanently attached to a hollow shaft and an attachable knurled handle. The shaft is constructed of stainless steel having sufficient rigidity. This tunneling instrument is designed, having multiple curves, which will allow the user to manipulate it in different directions while providing smooth contours during tunneling. The multiple curved design of this improved upon invention will allow the user to have full control during use; thereby preventing increased trauma to the surrounding tissues when tunneling. Due to the unique design of the current invention, the breast is given a more natural appearance after surgery.

Abstract: A blunt dissector for separating a blood vessel from surrounding tissues in a body comprises a longitudinal rod having a proximal end, a distal end, and an internal passage for conducting insufflation gas between the proximal and distal ends. An interior sleeve is mounted within the longitudinal rod for receiving an endoscope at the proximal end. A transparent tip is mounted to the distal end of the longitudinal rod. A handle is mounted to the proximal end of the longitudinal rod. The longitudinal rod has an outer surface along substantially all of the longitudinal rod between the proximal and distal ends consisting essentially of a fluoropolymer.

Abstract: An introducer and method provides a surgical tool with a pathway through tissue to a surgical site, wherein the surgical tool includes at least one surgical instrument. The introducer comprises a flexible sheath having a distal portion including a distal end and is arranged for receiving the surgical tool. A tissue separation tip at the distal portion of the sheath advances the sheath into the tissue towards the surgical site. The tissue separation tip is arranged to form a tissue gap and provide the at least one surgical instrument access to the tissue gap for performing a medical procedure consonant with the formation of the tissue gap or the performance of work at the surgical site.

Abstract: A varicose vein dissector and removal apparatus includes a handle having a first end and a second end, a dissector extending from the first end of the handle and a hook extending from the second end of the handle, and a blade positioned within the dissector for movement between a use position and a storage position. The apparatus is used by creating an initial incision in skin over a varicose vein to be removed, advancing the dissector into the incision and dissecting around the varicose vein to be removed, pushing the dissector against an inner surface of the skin a predetermined distance from the initial incision, exposing the blade by moving it from its storage position to its use position and creating a second incision in the skin letting the dissector protrude out of the skin, and grasping the vein with the hook and removing the vein.

Abstract: An instrument guide and method for use. An elongate flexible body has a proximal end and a distal end. The elongate body has two portions, one or more resilient than the other. A distal pocket is positioned adjacent the distal end of the elongate flexible body. An anchor is provided to attach the guide to a surgical instrument.

Abstract: The present invention provides balloon dissection apparatus and methods of use in which an elongate balloon is utilized to dissect along a region that follows a naturally existing path alongside a vessel or structure, such as an artery, a vein, a lymphatic vessel, the trachea, the esophagus, or even a nerve bundle.

Abstract: The present invention refers to a device and a method for subcutaneous detachment of the face, the leg, the thigh, the breast, the abdomen and the forehead, facilitating the full detachment of the skin from the underlying (adipose) tissue with substantial reduction in bleeding, better skin cutting quality, lesser amount of post-op edema, decreased surgery time, minimization of ecchymoses, prophylaxis of facial nerve injuries, and above all, minimized formation of post-op hematomas.

Abstract: An obturator assembly for penetrating tissue and being at least partially positionable within a cannula assembly includes an obturator housing, an obturator shaft connected to the obturator housing and defining a longitudinal axis, a bladeless penetrating member adjacent the distal end of the obturator shaft and an obturator shield mounted about the obturator shaft and having a distal shield nose. The obturator shield is adapted for longitudinal movement between an extended position where the bladeless penetration member is substantially enclosed within the shield nose and a retracted position where the bladeless penetrating member is at least partially exposed from the shield nose.

Abstract: A surgical instrument equipment appropriate for mini-invasive surgery, inserted through natural orifices or incisions, made up by a device to have access to the patient's body, that is comprised by a rigid ring from which at least two extensions stem out in distal direction, which extensions act as separators and a multivalve flexible head which, when in use, is provided enveloping the external side of said rigid ring, and that comprises: at least one operative conducting duct for the access of at least one working instrument; a connector to insufflate and irrigate fluids; and a funnel to retain fluids that holds said multivalve flexible head that envelops the rigid ring, defining when assembled, a passage for said working instrument that is provided within at least a conducting duct and, in turn, is comprised by a clamp handle, a movement transmission element made by an external tubular sheath, a driving chuck and a clamp head is including an intrahead device.

Abstract: A fluid injection device that injects a fluid to a biological tissue from an injection opening to excise the biological tissue, includes: a fluid injection means that injects the fluid from the injection opening; and a suction means that sucks at least one of the injected fluid and the excised biological tissue by periodically varying a negative suction pressure.

Abstract: An apparatus for shielding a body structure during surgical procedures which is configured for insertion into the internal passage of a support structure, and includes an elongated body portion with a distal tip portion configured to cover the body structure without substantially displacing the body structure. The apparatus also includes a mounting portion at a proximal end portion thereof for mounting the apparatus within the internal passage of the support structure, and a member connected to the mounting portion to release the mounting portion with respect to the internal passage of the wall portion.

Abstract: Systems and methods for extraction of implanted articles are disclosed. According to aspects illustrated herein, there is provided a system for extraction of an implanted article that includes an elongated member and a guide member disposed at a distal section of the elongated member. The guide member may define a pathway through which an implanted article can be securely received. The device can further include a dissection mechanism, coupled to the elongated member and designed to be positioned about the implanted article, for dissecting a fibrous adhesion about the implanted article.