Abstract: A system and related methods for performing nerve detection during surgical access using ultrasound testing during surgery.

Abstract: Systems and methods for image detection during grasping and stapling include an end effector having a first jaw and a second jaw, an imaging sensor mounted to the end effector and configured to capture images of a material graspable by the end effector, and one or more processors coupled to the end effector and the imaging sensor. The one or more processors are configured to receive the images from the imaging sensor, determine one or more properties of the material based on the images, and display the one or more properties of the material on an interface. In some embodiments, the end effector is part of a medical tool and the material is anatomical tissue. In some embodiments, the end effector further includes one or more of a stapling mechanism configured to staple the material or a cutting mechanism configured to cut the material.

Abstract: Aspects of this disclosure relate to catheter assemblies, that include an inner tube component, an outer tube component that fits over the inner tube component, and a disposable layer of film that isolates the otherwise fluid-exposed portions of the catheter from the fluid it drains. This disposable film can be removed at regular intervals and obviates the need for catheter exchanges as the isolating disposable film, rather than the catheter itself, is removed. The principal characteristic of the disposable film is that it is relatively impermeable to fluid, for example, bodily fluids.

Abstract: The invention relates to a device and method for blocking air contributing to pneumothorax during a lung biopsy.

Abstract: An insertable catheter device includes a shaft including a proximal end and a distal end, an expandable balloon, and an actuator configured to expand and retract the expandable balloon. The actuator includes a fluid conduit that extends through the shaft and is coupled with the expandable balloon to enable inflation and retraction of the expandable balloon via injection or withdrawal of a fluid to or from the expandable balloon via the fluid conduit. The expandable balloon is displaceably retractable into the shaft and extendable from the shaft. A fluid pump is coupled with the fluid conduit to pump the fluid through the fluid conduit. A patch is positioned to be displaced by the expandable balloon when the expandable balloon is inflated, and the expandable balloon is displaceably retractable into the shaft and displaceably extendable from the shaft.

Abstract: Apparatus and methods are provided for closing a tubular structure within a patient's body. The apparatus includes a needle including a proximal end including a hub, a distal end including a sharpened distal tip, a lumen having an oblong cross-section extending proximally from the distal end, and defining a longitudinal axis between the proximal and distal ends, and a clip deliverable from the lumen. The clip is compressible between a relaxed state in which a plurality of tines of the clip are shaped to engage and close a tubular structure within a patient's body, and a stressed state in which the tines are compressed to allow the clip to be loaded into the. The apparatus may also include a pusher member for deploying the clip from the distal tip of the needle such that the tines engage and close a tubular structure through which the tubular member is directed.

Abstract: A tissue clipping device and system, and method for clipping tissue are disclosed. The tissue clipping device includes a clip with clip arms that is slidably disposed within a channel of a lock tube. The clip is designed to move between an open configuration in which distal ends of the clip arms are separated from each other for receiving tissue therebetween, and a closed configuration in which the distal ends of the clip arms are closer to each other than in the open configuration for clipping the tissue received therebetween. The tissue clipping system further includes a delivery device for delivering and deploying the tissue clipping device. The delivery device is releasably coupled to the tissue clipping device.

Abstract: An exemplary valve repair device for repairing a native valve of a patient includes a coaption element, a pair of paddles, and barb portions. The barb portions extend directly from at least one of the coaption element and the pair of paddles.

Abstract: Embodiments of a simulated valve device can be used to determine whether a valve device would fit within a particular airway. The simulated valve device can include a shaft having at least one strut extending radially therefrom. The strut and at least part of the shaft can be surrounded by a membrane for viewing through a bronchoscope. In some embodiments, the membrane can include markings for viewing by a user.

Abstract: A closure device for sealing a percutaneous puncture in a wall of a body passageway, the closure device including at least one of a toggle configured to engage an interior surface of the body passageway or a plug configured to engage an exterior surface of the body passageway and a guide wire configured to extend from an outside of the body to inside the body passageway, wherein at least one of the toggle and the plug is associated with the guide wire.

Abstract: A vascular closure device configured to seal a puncture site in the vessel wall in a more efficient manner is disclosed. The vascular closure device includes a guide member that extends through a portion of the sealing device and that is removable from the portion the sealing device.

Abstract: An embolic material which prevents flow of a biological fluid by being placed in a body lumen via a catheter, the embolic material comprising a material that swells by contacting the biological fluid. The embolic material includes a long filler that is formed smaller than an inner diameter of the catheter. The filler prevents the flow of the biological fluid by bending when brought into contact with the biological fluid due to the difference in swelling characteristics between a first side portion and a second side portion that extend parallel to one another in a longitudinal direction.

Abstract: A device, method, and use of a device for temporary management of a wound, such as a wound in a heart. The device has a shaft, a blood flow blocking membrane at the first end of the shaft for blocking blood flow through the wound, and an abutment member that is mounted to the shaft and is axially movable along the shaft towards and away from the blood flow blocking membrane for abutting the wound and holding the blood flow blocking membrane adjacent the wound. The blood flow blocking membrane is resiliently flexible and movable between at least a first collapsed state for inserting the blood flow blocking membrane through the wound, and a deployed state for blocking blood flow through the wound.

Abstract: A system for controlling a robotic end-effector is disclosed. The system includes a robotic arm, a surgical tool including an end-effector with articulatable arm and a clamp jaw. A tool driver is coupled to the surgical tool and a motor is coupled to the tool driver and is configured to drive the surgical tool. A sensor is configured to sense external forces applied to the end-effector. A central control circuit is configured to control the tool driver. The central control circuit is configured to receive a sensed parameter from the sensor, receive a sensed motor current (I) from the motor, and control the tool driver based on the sensed parameter and the motor current (I).

Abstract: Embodiments of the present invention provide an improved vascular occlusion device for occlusion of a passageway, cavity, or the like. According to one embodiment, a medical device for occluding a left atrial appendage is provided. The medical device includes a first portion having at least one plane of occlusion that is configured to be positioned outside of the left atrial appendage, and a second portion having at least one plane of occlusion that is configured to be at least partially positioned within a cavity defined by the left atrial appendage.

Abstract: A vascular occlusion device having an expandable frame that carries a membrane. The membrane can include a tubular portion configured to transition between an open configuration in which the tubular portion is configured to receive a guidewire and a closed configuration in which the tubular portion is configured to occlude blood flow.

Abstract: A device for closing an aperture in a vessel wall including a covering member positionable inside the vessel against the internal opening of the aperture and having a dimension to prevent egress of fluid through the aperture. The covering member has a proximal surface and a distal surface, the distal surface having a concave surface and the proximal surface having a raised surface, wherein four openings are positioned in the raised surface. First and second retainers are positionable external of the vessel and first and second connecting members advance the respective first and second retainers toward the covering member.

Abstract: An atrial appendage closure device is provided that includes an insertion rod having a first end and a second end. An occluding member having an outer surface and an inner surface is connected to the first end of the insertion rod. The occluding member is moveable between a retracted position and a deployed position such that, in the deployed position, the occluding member is configured to provide a seal between a left atrial appendage and a left atrium of a heart. An anchoring member is further connected to the insertion rod and is configured to slide along the insertion rod to secure the device to a wall of a left atrial appendage. Methods for occluding a left atrial appendage that make use of the closure devices are also provided.

Abstract: The invention provides a clamping instrument and a clamping assembly, which mainly comprises a positioning base, a moving base, at least two clamping arms connected with the moving base, at least two linkage arms respectively connected with each of the clamping arms and the positioning base, and an actuating rod respectively penetrating through the positioning base and the moving base, wherein the positioning base is rotated circumferentially and fixed axially relative to the actuating rod, and the moving base is rotated circumferentially and moves axially relative to the actuating rod; when the movable rod is rotated circumferentially, a distance between the moving base and the positioning base can be changed, and then each of the clamping arms is linked to be rotated around the moving base to be in an unfolded position or a clamped position so as to clamp a preset site of a human tissue.

Abstract: The present technology is directed generally to devices, systems, and methods for enclosing anatomical openings. In one example, an aneurysm device is endovascularly deliverable to a site proximate to an arterial aneurysm. The aneurysm device can include a closure structure having a distal-facing aspect configured to at least partially occlude the aneurysm and a proximal-facing aspect configured to arch over lumina of an artery. The closure structure can include a plurality of struts forming support arms and anchoring arms. The device further includes a supplemental stabilizer connected to the closure structure and configured to reside in the artery and press outward against a luminal wall thereof. A barrier can span at least a portion of the distal-facing aspect of the closure structure and be configured to further occlude a neck of the aneurysm. The closure structure can be configured to restrict and/or divert flow to or from the aneurysm.

Abstract: A catheter system for atraumatic placement along a guidewire includes: a catheter including a cylindrical catheter body that defines a longitudinally extending interior lumen; and a guide device. The guide device includes: a conduit member for insertion into the interior lumen of the catheter body; a leading structure connected to a forward end of the conduit member, the leading structure including a cone and a sleeve extending forward from the cone; and an inner guide hole extending longitudinally through the leading structure and conduit member. In use, the guide device and catheter body are coaxially arranged, the cone is forward of the catheter, and the sleeve extends forward from the cone. The cone includes a shoulder, and a tapered exterior that increases diametrically from the sleeve to the shoulder. The shoulder abuts a distal end of the catheter to register insertion of the guide device in the catheter.

Abstract: A method for anatomical diagnosis includes measuring, using a catheter that includes a position sensor and an electrode, over multiple cycles of a beating heart, electrical activity and mechanical motion at a plurality of locations contacted by the catheter on a heart wall within a chamber of the heart. Based on the measured mechanical motion, a magnitude of a mechanical strain is computed over the cycles at the locations. In one embodiment, the computed strain is used in identifying a group of the locations at which the magnitude of the mechanical strain is below a predefined strain threshold and a voltage of the electrical activity is below a predefined voltage threshold as a locus of scar tissue. In another embodiment, a pathological condition of the heart is identified based on a characteristic of the mechanical strain computed over the left ventricle during the diastolic phase.

Abstract: Expandable occlusive plugs and methods of using them are disclosed. The devices generally include a tubular body bearing multiple slits defining leaves, which expand radially outward when the ends of the device are brought toward one another.

Abstract: A delivery device 100 includes a catheter assembly 120 and an operating handle 130. The operating handle 130 may include a nose 131 affixed to the catheter assembly 120, an axial shaft 180, a base 132 translationally fixed to a proximal end of the axial shaft, a screw 160 having external threads and a non-circular lumen 161, the axial shaft extending through the non-circular lumen, a proximal end 171 of a pull wire 170 being affixed to the screw, a knob 150 having internal threads engaged with the external threads of the screw, and a collar 140 extending at least partially around the axial shaft. When the collar 140 is in a proximal position, rotation of the knob 150 may deflect the distal end 121 of the catheter assembly 120. When the collar is in a distal position, rotation of the knob 150 may rotate the catheter assembly 120.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an access valve that may be retrieved after implantation. The access valve may include a frame having a lumen, a self-expandable member extending through the lumen, and an elastic membrane extending through the lumen and a second end of the frame to releasably seal the lumen. The access valve may releasably attach to a wall of a patient and releasably seal an opening through the wall. The access valve may be attached to the wall by placing the frame adjacent the wall, extending the self-expandable member through the opening in the wall, and expanding the self-expandable member such that the self-expandable member applies a first force against the wall and a second force opposite the first force against the frame to sandwich the wall between the self-expandable member and the frame.

Abstract: A soft suture anchor construct is provided for placement in or against tissue or bone. The anchor includes an all-suture anchor having two ends positioned in a first direction in a pre-deployment configuration. In a deployed configuration, the two ends are positioned in a second direction different from the first direction. The suture anchor construct also includes a filament passing through the anchor at a plurality of passing locations, where the filament changes direction at least once along the direction of the longitudinal axis of the anchor and forms at least one slack line. In the pre-deployment configuration, the filament extends a first length between adjacent passing locations, and in the deployed configuration, the filament extends a second length between adjacent passing locations. The second length is shorter than the first length. The suture anchor construct may be deployed in a bone hole with an inserter, anchor driver, or other deployment device.

Abstract: A wound closure system includes a device having a first main body and a second main body. Each of the first main body and the second main body has an adhesive backing. The first main body is coupled to the second main body by an adjustable connector. The adjustable connector is permitted to move in a single direction. In the event of an injury, the first and second main bodies are placed on opposite sides of a wound and are then pulled together, thereby sealing the wound.

Abstract: A biocompatible polymeric composition for cross-linking in-situ in a wound is disclosed comprising 1) one or more polyanionic polymers such as alginates or hyaluronates, able to be cross-linked the surface of the wound and 2) one or more polycationic polymers such as chitosan or DEAE-Dextran, that assists in the solidification process as well as speeds up hemostasis without the need for applying pressure. The biocompatible polymeric composition may further comprise a cross-linking agent such as aqueous calcium chloride. The invention encompasses an initial polymeric composition, the solidified matrix cross-linked and integrated at the wound site, including the methods of using, applying, and cross-linking the composition.

Abstract: A surgical delivery instrument for delivering a vascular hole closure device having a hole covering member. The delivery instrument comprises a housing, a plunger and an advancer movable within the housing, the advancer having a first portion and a distal portion hingedly connected to the first portion and forming a casing for supporting the hole covering member. Distal movement of the advancer pivots the casing from an angled position to a more linear position to change the orientation of the covering member from a transverse position to a more aligned position. The plunger is advanceable to advance the covering member into the vessel.

Abstract: A left atrial appendage occluder with advanced connection manner and a manufacturing method thereof are provided. The left atrial appendage occluder includes a sealing portion and an anchoring portion. Each of the sealing portion and the anchoring portion is provided with a connection part formed by converging a corresponding shape of the sealing portion or the anchoring portion respectively. The connection parts of the sealing portion and the anchoring portion extend toward each other to be fixed and misaligned with each other.

Abstract: In one embodiment, the present invention provides a composition, wherein the composition is a porous scaffold, wherein the pores of the scaffold are from 1 to 500 microns, the composition comprising: a) a cross-linkable protein selected from the group consisting of collagen and gelatin; b) a cross-linker which induces cross-linking of the cross-linkable protein; and c) a liquid.

Abstract: An adjustable artificial chordae tendineae fixing assembly includes an occlusion device and an adjusting rod which are both a hollow structure allowing the artificial chordae tendineae to pass through. The occlusion device is configured to be clamped on the interventricular septum. The occlusion device is provided with a switch adjusting device which controls the artificial chordae tendineae to move and to be fixed. The adjusting rod is connected to the occlusion device, and is capable of repeatedly adjusting the switch adjusting device on the occlusion device. The artificial chordae tendineae fixing assembly can fix the artificial chordae tendineae on the interventricular septum, and can also overcome the problem of unsuitable length of the artificial chordae tendineae in most of patients after the procedure due to cardiac changes. The artificial chordae tendineae is retained at the skin puncture point for a short time.

Abstract: Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, includes an occlusive device comprising a mesh having a low-profile state for intravascular delivery to the aneurysm and a deployed state, the mesh comprising a first end portion, a second end portion, and a length extending between the first and second end portions, and a first lateral edge, a second lateral edge, and a width extending between the first and second lateral edges. The mesh may have a predetermined shape in the deployed state in which (a) the mesh is curved along its width, (b) the mesh is curved along its length, and (c) the mesh has an undulating contour across at least a portion of one or both of its length or its width. The mesh is configured to be positioned within the aneurysm in the deployed state such that the mesh extends over the neck of the aneurysm.

Abstract: Devices and methods for treatment of a patient's vasculature are described. Embodiments may include a permeable implant such as a permeable shell or mesh having a radially constrained state configured for delivery within a catheter lumen, an expanded state, and a plurality of elongate filaments that are woven together. The permeable implant may include a stiffer proximal portion that is configured to sit at the neck of an aneurysm. The stiffer proximal portion may include additional mesh layers on either the inside or the outside of a first permeable shell. The distal portion of the device may be softer and deformable.

Abstract: The disclosed technology provides a device for sealing an aperture in a tissue of a body lumen. The device comprises a flexible support member having a base having (i) a central portion and (ii) one or more lateral support portions, to engage and/or hold a sealable member of the device against an interior surface of the tissue when the device is in the sealing position. The lateral support portions provide additional support surfaces to engage peripheral portions of the sealable member against the interior surface of the tissue. A cage or shoe engaged with the support member on the exterior surface of the tissue can provide additional support and assist sealing the aperture.

Abstract: An occluder and an occlusion device, including: a mesh occlusion body, which defines a cavity, and a proximal end bolt head; the proximal end bolt head configured with a locking hole which penetrates the cavity; the occluder further having a locking member, a distal end of the locking member being connected to a distal end of the occlusion body; the locking member having a connecting portion which is connected to the occlusion body; the diameter of a circumscribed circle of a projection of the first bending portion on a cross section perpendicular to a length direction thereof being smaller than the diameter of the smallest inscribed circle of a locking hole, and the width of a projection of the first bending portion on a plane perpendicular to longitudinal central axis direction of the locking hole being larger than the diameter of the largest inscribed circle of the locking hole.

Abstract: The present invention provides a tissue anchor and a system and method employing same, the anchors including a body having a first section and a second section reversibly engagable with one another, each section including a plurality of barbs in the form of microneedles projecting from the underside therefore, the barbs on one section being inclined towards barbs on the other section, such that tissue may be captured and deformed between the barbs through displacement of the first section relative to the second section in order to achieve robust retention of the tissue anchor at a deployment site.

Abstract: Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.

Abstract: Prosthetic heart valve devices and associated methods for percutaneous or transcatheter heart valve replacement are disclosed herein. A heart valve prosthesis configured in accordance herewith includes a frame having a valve support and a plurality of support arms extending therefrom. The plurality of support arms may include a main support arm configured to extend from the valve support for capturing at least a portion of a valve leaflet of a native heart valve therebetween when the valve prosthesis is in an expanded configuration and deployed within the native heart valve. In addition, the plurality of support arms may include multiple supplemental support arms disposed about the circumference of the valve support that when deployed in the expanded configuration are configured to at least partially engage subannular tissue at the native heart valve.

Abstract: Heart valve replacement often involves complications associated with paravalvular leaks. Vascular plug and occlusive devices, as well as heart valves particularly beneficial in treating the phenomenon of paravalvular leaks are described to address this issue.

Abstract: A knotless self-cinching suture construct device includes a shuttling suture, a continuous loop and a self-cinching suture member. The shuttling suture is configured for insertion into a passage hole in injured soft tissue, such as a torn or damaged meniscus in the knee. The shuttling suture and continuous loop are passed entirely through the passage hole in the tissue, and the self-cinching suture member is inserted through the continuous loop to form a hitch using the continuous loop around the tissue. The self-cinching suture member is then pulled tight, allowing a first strand to slide through both the hitched continuous loop and a self-cinching sleeve on the suture member. When tension is applied, the sleeve tightens around the strand much like a finger trap, preventing inadvertent release of the applied suture tension. The suture construct is configured for use through a transosseous tunnel with a suture button in some embodiments.

Abstract: A left atrial appendage occluder, including a closure disc, a bracket located on one side of the closure disc, and a connecting member connecting the closure disc and the bracket; the bracket includes a first fixing connection member, a second fixing connection member, and a number of support rods; the first ends of the plurality of support rods are collapsed and secured by the first fixing connection member; the second ends of the plurality of support rods are collapsed and secured by the second fixing connection member; a connecting member is connected to the first fixing connection member. The bracket is arranged such that the two ends constituted by at least two support rods have a closed structure, thus increasing the area of contact between the outer surface of the bracket and the left atrial appendage.

Abstract: A method for delivering an implant including, a catheter having a shaft defined by a proximal end and a distal end and a bore extending therethrough; a first joint in the shaft, and a second joint in the shaft located distal of the first joint. The first joint and the second joint are separated by a first digit sized to receive the implant and located between the first joint and the second joint. The second joint and the distal end are separated by a second digit being sized to receive the implant. The implant is advanced through the first digit and into the second digit without bending the implant or the first and second digits by rotating the digits at the first joint and the second joint.

Abstract: A fixation device for securing together leaflets of a heart valve is provided. The fixation device may comprise two plates that are disposed on either side of the tricuspid valve. The plates may be secured to one another by a locking clip, thereby securing the valve leaflets between the plates.

Abstract: An asymmetric occlusion device for occluding an opening in a body tissue where part of the opening is defined by a partial inadequate rim. The asymmetric occlusion device includes a waist portion having a distal end extending to a proximal end. The waist portion is of non-woven material extending around a longitudinal axis opening. The occlusion device further includes a pair of asymmetric occluder disks attached to the waist. The asymmetric distal and proximal occluder disks are formed of shape memory material. The asymmetric occluder disks include a short arm extending from the waist and an extended arm extending from the waist. The extended arm exceeds the length of the first short arm. The density of the first short arm exceeds the density of the second extended arm.

Abstract: A collapsible medical device is used for occluding an opening used for fetoscopic surgery. The device includes tubular woven metal fabric composed of braided metal strands, said woven metal fabric having an expanded preset configuration comprising an hourglass-shaped element and a waist element at a midpoint, wherein each end of the hourglass-shaped element has a diameter of about 5 mm, wherein the waist element has a diameter that is less than a diameter of each end of the hourglass-shaped element, said woven metal fabric further includes a bulbous element coupled to one end of the hourglass-shaped element via a shaft, wherein the woven metal fabric is deformable to a lesser cross-sectional dimension for delivery through a channel in a patient's body to said opening, and the woven metal fabric having a memory property whereby the medical device tends to return to said expanded preset configuration when unconstrained.

Abstract: A left atrial appendage occluder and a fabricating method thereof are provided. The left atrial appendage occluder includes a plugging column and a anchor located on the plugging column, wherein the plugging column is woven from an elastic metal wire, or woven from an elastic metal wire and an elastic metal sheet, the anchor is made by partially flattening and then cutting the elastic metal wire, or the anchor is made by cutting the elastic metal sheet. In the above-described left atrial appendage occluder, firstly, the anchor is formed on the elastic metal wire and/or the elastic metal sheet, and then the elastic metal wire and/or the elastic metal sheet with the anchor are/is co-woven with other elastic metal wire to form the plugging column of the left atrial appendage occluder. Therefore, the amount of the anchor is not limited, and a plurality of anchors can be provided.

Abstract: A system to facilitate sealing a puncture of a vessel includes an implant having first and second expandable sections, and a delivery device that includes an inner tube and a circumscribing outer tube. The outer tube defines a first lumen configured to retain the implant, and a second lumen configured to channel fluid from the vessel through a distal opening proximal to the implant. A pusher circumscribed at least partially by the outer tube is configured to compress the implant to selectively expand the first and second expandable sections. The outer tube is selectively retractable relative to the inner tube such that the first expandable section remains substantially within the first lumen and the second expandable section is positioned outside of the first lumen. The outer tube is further selectively retractable relative to the inner tube such that the first expandable section is positioned outside of the first lumen.

Abstract: Collapsible tube embodiments may be used to promote hemostasis at surgical sites or any other suitable location. In some cases, vascular closure device embodiments may include collapsible tube embodiments in order to promote hemostasis at a surgical site during a vascular closure procedure.

Abstract: Methods of implanting a device in the lumen of a blood vessel are described. The method includes providing a microcatheter and a device. The device includes a first hub, a second hub, a support structure including a plurality of struts disposed between the first hub and the second hub, and a layer of material disposed over the plurality of struts. The support structure has a low profile, radially constrained state with an elongated tubular configuration suitable for delivery from a microcatheter. The support structure also has an expanded state, a smooth outer surface, and has an axially shortened configuration relative to the radially constrained state. The microcatheter is advanced to a region of interest within the blood vessel. The support structure is advanced through the lumen of and out the distal end of the microcatheter where it expands to the expanded state.