Abstract: The invention provides a wound dressing made by an ex vivo formed combination of fibrinogen and/or fibrin containing-liquid formulation and an oxidized cellulose (OC) backing; and use thereof.

Abstract: A device for sealing an aperture in a tissue includes: a foot including a distal portion configured to be disposed distal to the tissue when the device is implanted in a position to seal the aperture; and a flexible wing positionable against a distal surface of the tissue adjacent the aperture such that the flexible wing is disposed between the distal portion of the foot and the distal surface adjacent the aperture.

Abstract: A medical device and a treatment method, in which energy is accurately applied to a target site by suppressing a positional displacement between an expansion body and a biological tissue. The medical device includes an elongated shaft portion and an expansion body disposed in a distal portion of the shaft portion and configured to expand and contract in a radial direction. The expansion body includes a holding portion having a proximal side holding portion and a distal side holding portion configured to hold the biological tissue, and a movable portion configured to open and close the holding portion.

Abstract: An occlusion device (210) is provided for occluding a left atrial appendage (LAA), including a compliant balloon (230) defining a fluid-tight balloon chamber (232), and an actuating shaft (234), which is disposed at least partially within the balloon chamber (232) for setting a distance between distal and proximal end portions (236, 238) of the balloon (230). A proximal LAA-orifice cover (70) includes a frame (72) and a covering (74) fixed to the frame (72). An orifice-support stent (290) is fixed to and extends distally from the proximal LAA-orifice cover (70), and is generally cylindrical when in a radially-expanded state. Other embodiments are also described.

Abstract: An implant for occluding a left atrial appendage may include an expandable framework configured to shift between a collapsed configuration and an expanded configuration, wherein the expandable framework includes an attachment point configured to secure the expandable framework to a delivery device, and an occlusive element disposed on a proximal portion of the expandable framework, wherein the occlusive element covers the attachment point.

Abstract: One aspect of the invention provides a slurry comprising: a plurality of sterile ice particles having a largest cross-sectional dimension less than about 1.5 mm; and a biocompatible surfactant. Another aspect of the invention provides a slurry including: a plurality of sterile ice particles having a largest cross-sectional dimension less than about 1.5 mm; a biocompatible surfactant; and a foam comprising a plurality of gas bubbles. Another aspect of the invention provides a slurry including: a plurality of sterile ice particles having a largest cross-sectional dimension less than about 1.5 mm; and a biocompatible excipient. Another aspect of the invention provides a slurry including: a plurality of sterile ice particles having a largest cross-sectional dimension less than about 1.5 mm; and a lipolytic agent.

Abstract: A surgical instrument includes a drive housing, a spline, a carriage, an elongate shaft assembly, an end effector, and an activating mechanism. The at least one spline includes a drive gear rotatable with the spline. The elongate shaft assembly extends from the carriage. The activating mechanism includes a barrel cam extending along a rotational axis and having a first cam profile radially extending about the rotational axis. The barrel cam is operatively coupled to the drive gear such that rotation of the drive gear is configured to actuate the activating mechanism to move at least a portion of the end effector. The first cam profile defines a plurality of slopes relative to the rotational axis such that the first cam profile is configured to drive movement of the end effector or the elongate shaft assembly at different rates according to the plurality of slopes.

Abstract: Apparatus and methods for sealing a puncture through tissue includes an introducer sheath sized for introduction into a puncture, cartridge sized for insertion into the introducer carrying a sealant, and a locking element for coupling the introducer sheath to the cartridge. When the cartridge is advanced into the introducer sheath, the locking element couples the introducer sheath to the cartridge such that subsequent retraction of the cartridge causes the introducer sheath to retract, thereby deploying the sealant from the cartridge within the puncture beyond the introducer sheath.

Abstract: The present invention provides an improved vascular occlusion device having improved flexibility and retention of the type fabricated from braided tubular metal fabric having an expanded preset configuration and an elongated collapsed reduced diameter configuration for delivery through a catheter to a treatment site and shaped to create an occlusion of an abnormal opening in a body organ or vessel, the woven metal fabric having a memory property whereby the medical device tends to return to said expanded preset configuration when unconstrained. The device further including at least one disk portion adjacent a body cylindrical portion formed from the fabric and having a transition diameter between the disk and cylindrical portion, significantly smaller than the diameter of the disk and the diameter of the cylindrical portion.

Abstract: A medical device may include an outer assembly having a first shaft, a first lumen extending through the first shaft, and an atraumatic first tip removably coupled to a distal end of the first shaft; an inner assembly configured to extend through the first lumen of the outer assembly, the inner assembly including a second shaft, a second lumen extending through the second shaft, and a second tip removably coupled to a distal end of the second shaft, the second tip being configured to pierce tissue; and a plug assembly configured to extend through the second lumen of the inner assembly, the plug assembly including a third shaft and a plug removably coupled to a distal end of the third shaft.

Abstract: A device for performing minimally invasive repair of mitral valve leaflets in a beating heart through the delivery and implantation of artificial chordae tendineae includes a handle for positioning the device into a chest cavity of the patient, a capture assembly adapted to capture a valve leaflet between distal an proximal tip portions, a needle adapted to penetrate the valve leaflet, and a capture confirmation system for verifying capture of the valve leaflet between the distal and proximal tip portions.

Abstract: System for inserting a self-expandable occluder into a patient and for releasing the occluder in the left atrial appendage of the patient, the system including an insertion unit which has a drive unit and an insertion catheter having an outer tube and an inner tube extending through the outer tube, wherein a proximal end region of the occluder is movement-coupled to the outer tube, and wherein a distal end region of the occluder is movement-coupled to the inner tube.

Abstract: In various examples, an apparatus is configured for subcutaneously inserting an implantable device within a patient. The apparatus includes a dilator portion including a dilator including a dilator length. The dilator portion is configured to separate tissue to create a subcutaneous pocket within the patient sized and shaped to accommodate an implantable device within the subcutaneous pocket. A sheath portion includes a sheath sized and shaped to accommodate the dilator within a sheath lumen. The sheath is configured to accommodate an antenna of the implantable device with the dilator removed from within the sheath. The sheath includes a sheath length that is at least substantially as long as an antenna length. The sheath is configured to separate to allow removal of the sheath around the implantable device to remove the sheath from and leave the implantable device within the subcutaneous pocket within the patient.

Abstract: An occlusion device includes a sealing disc, and a fixing frame connected to the sealing disc and located on one side of the sealing disc. The fixing frame includes a connecting portion connected to the sealing disc and at least one supporting body. The at least one supporting body radiates from the connecting portion and extends towards a proximal end to form a plurality of supporting sections. The supporting section is provided with at least one first restraint portion. The fixing frame is provided with at least one second restraint portion. The occlusion device further includes at least one restraint member. The restraint member is connected to the first and second restraint portion so a portion of the restraint member between the first and second restraint portion generates a restraint force that restrains movement of at least the supporting section.

Abstract: An occlusion device includes an elongate shaft; a lower jaw extending from a distal end of the elongate shaft; an upper jaw pivotably mounted relative to the lower jaw; and a control member at a proximal end of the elongate shaft, the control member being operatively associated with the upper jaw to cause pivot of the upper jaw relative to the lower jaw. A method is also disclosed.

Abstract: A differential compression bone screw and a method are provided for compressing adjacent bone portions together to encourage bone fusion. The compression bone screw is comprised of a head portion and a shank. A center hole extends from the head portion to a distal end of the shank. A superior end of the head portion includes a shaped opening that receives a tool for driving the compression bone screw into a hole drilled in a patient's bone. An inferior end of the head portion includes barbs that engage with surrounding bone tissue. A smooth portion of the shank is disposed between proximal threads and distal threads that rotatably engage within the hole in the patient's bone. A thread pitch of the distal threads is greater than a thread pitch of the proximal threads, such that the compression bone screw comprises a differential pitch configured to compress the adjacent bone portions.

Abstract: A surgical instrument for use with a robotic system that has a control unit and a shaft portion that includes an electrically conductive elongated member that is attached to a portion of the robotic system. The elongated member is configured to transmit control motions from the robotic system to an end effector.

Abstract: A drug solution administration method using an inkjet device including an inkjet head that ejects a drug solution, and a controller that controls the ejection of the drug solution from the inkjet head, wherein the drug solution is made to pierce a target site and is administered to the target site by ejecting the drug solution from the inkjet head so that a diameter of the drug solution when it is ejected from the inkjet head is 20 ?m or more and 200 ?m or less and an ejection rate of the drug solution when it is ejected from the inkjet head is 30 m/s or more under control of the controller.

Abstract: An occlusion device for the left atrial appendage is plastically deformable and biodegradable.

Abstract: In various aspects, the invention relates to an embolic device for treating aneurysms or other vascular disorders that exhibits improved filling and/or neck blockage over conventional devices. As one example, the embolic device can include a structure that is wound into a spiral shape. In some cases, the spirally wound embolic device includes alternating narrow portions and link portions. As another example, the embolic device can be formed from a structure wound to form an infinity shape or, in some cases, multiple infinity shapes. In instances with multiple infinity shapes, the infinity shapes can be arranged either parallel or perpendicular to each other. In certain aspects, the embolic device can include two different embolic devices that are attached by an interconnect element, such that the two devices are attached but have independent freedom of motion when placed within a vascular disorder.

Abstract: An artificial chordae tendineae implantation system, including a clamping device, puncture device, a pushing device, and a clamp assistance device. The pushing device includes a pushing catheter. The puncture device and the clamping device respectively are movably insertedly mounted within the pushing catheter. An artificial chordae tendineae is accommodated in the clamping device. The clamp assistance device includes a clamp assistance arm movably insertedly mounted within the pushing catheter and a clamp assistance member provided at the distal end of the clamp assistance arm. The clamp assistant member is made of a flexible and/or soft material. The clamp assistance member and the clamp assistance arm are accommodated together in the pushing catheter. The clamp assistance arm pushes the clamp assistance member to pass out from the distal end of the pushing catheter or the distal end of the clamping device.

Abstract: A surgical instrument comprising an end effector, a staple firing drive, and a motor control system is disclosed. The end effector includes a replaceable unspent staple cartridge comprising staples. The staple firing drive comprises an electric motor circuit including an electric motor. The staple firing drive further comprises a firing member movable through a firing stroke by the electric motor. The firing member comprises a tissue cutting knife. The staples are deployable from the staple cartridge based on movement of the firing member through the firing stroke. The motor control system comprises a current sensor and a position sensor. The motor control system is configured to change the operation of the electric motor based on an input from the current sensor. The motor control system is configured to change the operation of the electric motor based on an input from the position sensor.

Abstract: A suturing device, in particular for suturing lacerations of the meniscus, including a needle provided with a longitudinal cavity developing along a main direction, at least a first and a second member slidably inserted in said cavity and arranged in succession along said main direction and a surgical thread slidably inserted in the cavity and connected to the first and the second member. The first and the second member each comprises at least a pair of bodies connected together by means of a junction element.

Abstract: Devices are provided with a bridge made of a biocompatible material that surrounds a neck region of an encapsulated shunt. In one embodiment, the bridge is configured to maintain an outer diameter while the diameter of the neck region is reduced or increased in vivo to adjust the fluid flow rate through the device. The bridge may have an outer diameter that is configured to be placed within an enlarged septal hole. Methods for adjusting the flow of fluid and methods for the manufacture of such devices are also provided.

Abstract: The present invention relates to a left atrial appendage occluder having a sealing disc and a fixing bracket which is connected to the sealing disc and located at one side of the sealing disc; the fixing bracket comprising a connecting portion connected to the sealing disc, and a plurality of supports. After radiating out distally from the connecting portion, the plurality of supports are bent to extend proximally to form a plurality of spaced suspended supporting segments. The left atrial appendage occluder further includes a thin film, with all the supports being connected through the thin film.

Abstract: A device for treatment of a vascular defect within a patient's vasculature includes a self-expanding permeable shell having a proximal end, a distal end, and a longitudinal axis, the shell comprising a plurality of elongate resilient filaments having a braided structure, wherein the filaments are secured at at least one of the proximal end or the distal end of the permeable shell, wherein the permeable shell has a radially constrained elongated state configured for delivery within a microcatheter and has an expanded state with an axially shortened configuration relative to the radially constrained state, the permeable shell having a plurality of openings formed between the braided filaments, wherein the permeable shell in its expanded state comprises a plurality of circumferentially-arrayed lobes.

Abstract: A method for adjusting the operation of a clip applier using machine learning in a surgical suite is disclosed. The method comprises gathering data during surgical procedures, wherein the surgical procedures include the use of a clip applier comprising a crimping drive configured to be mechanically advanced through a crimping stroke. The method further comprises analyzing the gathered data to determine an appropriate operational adjustment of the clip applier and adjusting the operation of the clip applier to improve the operation of the clip applier.

Abstract: Several embodiments disclosed herein relate to compositions and methods for treating or repairing damage to ocular tissue. In particular, several embodiments relate to patches that interact, e.g., by way of an adhesive, with damaged retinal tissue to repair or mend a hole, tear or detachment of the retina from underlying ocular tissue. Still additional embodiments relate to self-assembling patches.

Abstract: A surgical instrument for use with a robotic system that has a control unit and a shaft portion that includes an electrically conductive elongated member that is attached to a portion of the robotic system. The elongated member is configured to transmit control motions from the robotic system to an end effector.

Abstract: Some disclosed suture securement devices comprise a flat, thin, generally planar body that has one or more suture engagement slots extending into the body from a perimeter inlet for receiving sutures laterally into the device. The slots can be resiliently widened to receive a suture and then released to clamp onto the suture. Some embodiments include two or more such suture engagement slots that independently receive and secure different sutures. Some embodiments include one or more locking tabs that have a closed position that retains the slots against widening and blocks the inlet to the slot. In some embodiment two or more slots are position next to each other on the same side of the device, while in other embodiments slots are positioned on opposite sides of the device. Other types of suture securement devices are also disclosed.

Abstract: A shunt is described that expands to an hourglass shape. As the shunt expands, both of its ends radially flare outwards relative to its middle section and the length of the shunt foreshortens, which causes the flared ends to engage the tissue surrounding a puncture or aperture within a patient's tissue.

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: Tissue adjustment implants useful for adjusting a position of tissue in a patient are described. In an embodiment, a tissue adjustment implant includes a main body having a series of outwardly-extending projections. The tissue adjustment implants can be used in a variety of treatments, such as in the treatment of Obstructive Sleep Apnea and snoring.

Abstract: Closure devices for sealing a puncture and methods of sealing a puncture are described herein. A closure device may be used to position a sealant in a puncture. The sealant may be provided in a sheath which is retracted to expose the sealant in the puncture. A support member may be advanced to compress the sealant. The device may have a lock that prevents the support member from advancing prematurely. The lock may be unlocked when the sheath is at least partially retracted. The device may have an actuator that controls movement of the sheath and the support member. The lock may remain in a locked position until the sheath is at least partially retracted.

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: A bariatric clamp may include substrate members overmolded in polymer forming first and second elongated portions with insert portions, and a bight portion having a flexible hinge wherein the inserts are engaged via a magnetic force to retain the clamp in a closed position to partition the stomach. In another embodiment, the bariatric clamp may include substrate members overmolded in polymer forming first and second elongated portions and a bight portion having a flexible hinge, wherein the first and second elongated portions are curved to conform to a curvature of a patient's stomach. In another embodiment, the bariatric clamp may include substrate members overmolded in polymer forming first and second elongated portions each having one or more suture portions formed via one or more recesses formed in the substrate members.

Abstract: An implantable medical device for sealing and repairing defects in a body tissue or for creating an anastomosis includes a frame and a covering material. In some embodiments, the frame includes a single continuously wound wire that defines an apposition portion, a defect-occupying portion, and a sealing portion. In some embodiments, the tissue-sealing and anastomosis devices provided herein are well-suited for use in the GI tract including the small bowel and colon. In some embodiments, a two-part frame construct facilitates independent tailoring of apposition forces and radial forces exerted on tissues by the two-part frame.

Abstract: An apparatus for sealing a puncture includes a positioning member including a proximal end, a distal end sized for insertion into a puncture, an expandable element on the distal end, and a tension indicator on the proximal end. The tension indicator includes a distal housing portion fixed relative to the proximal end, and a proximal housing portion or handle movable proximally relative to the distal housing portion. The handle is biased towards the distal housing portion such that, when sufficient tensile force is applied between the expandable element and the handle, the handle moves away from the distal housing portion. During use, the distal end is introduced through a puncture into a vessel, the expandable element is expanded, and the positioning member is partially withdrawn until the expanded element contacts a wall of the vessel and the handle separates from the distal housing portion, indicating that sufficient tension is applied.

Abstract: An apparatus for sealing a puncture includes a cartridge, a pusher member, a sealant, and a tamping device on a proximal end of the cartridge. During use, the cartridge, sealant, and pusher member are advanced over a positioning member and into the puncture by advancing a cartridge hub carrying the tamping device. When further distal advancement of the cartridge is limited, the cartridge hub is further advanced, activating the tamping device, and causing the pusher member to advance relative to the sealant to compress the sealant within the puncture.

Abstract: Described are medical graft products, systems, and methods for treating fistulae. Certain products of the invention are configured to have portions residing in and around a primary fistula opening, e.g., one occurring in a wall of the alimentary canal. One such product includes a biocompatible graft body which is configured to block at least the primary opening. The graft body includes a capping member, which is configured to contact portions of the alimentary canal wall adjacent to the primary opening, and an elongate plug member extending from the capping member, which is configured to extend into at least a portion of the fistula. In certain embodiments, a graft body component has the capacity to expand or otherwise change form to provide a suitable capping arrangement. Such a component can include a resilient wire frame, e.g., one that is self-expandable or one that requires at least some manipulation in order to expand.

Abstract: A device for fracturing calcifications in heart valves including an expandable stabilizer and expandable impactor arms assembled on and deployed by a delivery system, wherein the delivery system is operable to move the impactor arms, while in an expanded position, with respect to the stabilizer with sufficient energy so as to fracture a calcification located in tissue which is sandwiched between the stabilizer and the impactor arms.

Abstract: In an embodiment, a compression garment can include one or more of a flex frame, a shape memory material, a backing, and a control module. In some variations, the flex frame can include a set of support regions, a set of cutout regions, a set of bridges, one or more terminals, and one or more rotation points. In some variations, the compression garment 100 can further include a fabric sleeve, one or more fasteners, a power module, and/or any other suitable component. The compression garment functions as a compression device (e.g., to improve circulation, enhance muscle recovery, etc.), and can additionally or alternatively function as a passive compression device, a heating and/or cooling device, or perform any other suitable functionality.

Abstract: Devices for closing a passage through tissue communicating with a body lumen. The device may include an elongate body, a sheath disposed at the distal end of the device for disposition within a body lumen, a hollow needle disposed within a needle lumen of the body, the needle being selectively advanceable through the needle lumen, a suture-anchor ejection mandrel disposed within the hollow needle that is also selectively advanceable through the hollow needle, a suture-anchor and suture disposed within the hollow needle, a distal end of the suture attached to the suture anchor for ejection out the hollow needle by the mandrel. A needle guide disposed between the sheath and proximal end of the body may include a needle port through which the needle can exit. A hemostatic plug is disposed over the needle port so as to be penetrated by the needle upon exiting the port.

Abstract: An embolic coil with a secondary, delivered shape utilizing regions of varying stiffness is described. In some embodiments, these regions of varying stiffness are created by utilizing a larger primary wind loop diameter to create selective regions with lower stiffness and higher flexibility. In some embodiments, these regions of higher flexibility correspond to inflection regions on a complex coil shape to ease deliverability of the coil during therapeutic procedures.

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.