An ultrasonic surgical instrument comprises a reusable housing including an internal transducer and an internal end effector rotation assembly. An exemplary rotation assembly is a ratchet and pawl assembly, which allows the transducer to rotate in a first direction but not in a second, opposite direction. The end effector, including an integral torque wrench, is attached to the transducer to form a single unit that is rotatable relative to the housing. The transducer attaches to a stationary cable via slip rings. The cable communicates with a generator, which provides electrical power to the transducer. The transducer converts the electrical power into ultrasonic vibrational energy, which is transmitted to the end effector.

An instrument for delivering a suture transfascially may include a handle, a shaft extending from the handle, and at least one needle that is moveable to an extended position beyond the end of the shaft. A suture may be delivered transfascially with the instrument. The instrument may include a suture catch associated with each needle for retaining and releasing a suture segment. A shield may be provided to shield the sharp end of each needle when it is moved to the extended position. A method of delivering a transfascial suture may include inserting an instrument into an abdominal cavity and deploying, from within the abdominal cavity, each needle through a soft tissue repair patch and then through at least part of the abdominal wall. A suture or suture segment may be advanced across the fascia with the at least one needle.

A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes. A tool is provided to aspirate excess fluid and tissue from the treatment area.

A multi-layer occluder for treating a target site within the body is provided. The occluder may include first and second layers. For example, the first layer may include braided strands of metallic material, and the second layer may include braided strands of polymeric material. At least one of the first or second layers may be configured to facilitate thrombosis.

A system for treating heart disease, such as pulmonary hypertension or right heart failure, including an implantable component and external components for monitoring the implantable component is provided. The implantable component may include a compliant member, e.g., balloon, coupled to a reservoir via a conduit. Preferably, the compliant member is adapted to be implanted in a pulmonary artery and the reservoir is adapted to be implanted subcutaneously. The external components may include a clinical controller component, monitoring software configured to run a clinician's computer, a patient monitoring device, and a mobile application configured to run on a patient's mobile device.

Braid-balls suitable for aneurysm occlusion and/or parent vessel occlusion/sacrifice (e.g., in treating neurovascular defects) are disclosed. Especially for aneurysm treatment, but also for either one of the aforementioned treatments, the form of the ball is very important. In particular, the density of the device is paramount in applications where braid itself is intended to moderate or stop blood flow—allowing thrombosis within a volume formed by the ball.

The present invention provides a method of deploying a medical filter within a channel in a patient's body and filter systems which can be used in such a method. Such a filter may include a radially expandable body 52 having an opening 56 in a proximal length thereof. In one method, the filter is urged along a length of the channel with the filter body in a radially reduced configuration. This body is expanded to substantially fill the lumen of the vessel and orient the opening in the body proximally. Body fluid is permitted to enter the filter body through the proximally oriented opening and pass distally through the distal length of the body so that the distal length of the body filters from the body fluid particulate material entrained therein. The proximal length of the body can be drawn into the retrieval catheter, thereby effectively closing the proximally oriented opening within the catheter to retain the particulate material within the enclosure. In a preferred embodiment, the filter body 52 is formed of a porous, resilient fabric having pores therein and the proximal opening 56 is at least five times the size of such pores.

A combined multi-lumen central access catheter and an embolic filter, further comprising an imaging modality to facilitate intravascular imaging of the filter.

A combined multi-lumen central access catheter and an embolic filter, further comprising an imaging modality to facilitate intravascular imaging of the filter.

Disclosed is a method and apparatus for regulating tourniquet cuff pressure based on a personalized tourniquet pressure (PTP) to facilitate safe performance of a surgical procedure. The apparatus includes a dual-purpose tourniquet cuff adapted to encircle a region of a patient limb to provide both a sensor during a pre-surgical time period and an effector during a surgical time period. An effector module communicates pneumatically with an inflatable bladder of the cuff for maintaining pressure in the bladder near a PTP during the surgical time period to safely stop penetration of arterial blood past the cuff. A pulsation sensor that communicates pneumatically with the inflatable bladder during the pre-surgical time period senses and characterizes pressure pulsations that are indicative of penetration of arterial blood into the region of the limb encircled by the cuff. A PTP estimator is responsive to the pulsation sensor for producing an estimate of the PTP, such that the estimate of the PTP is a function of the sensed pulsations.

A forceps includes first and second jaw members and at least one handle movable between an open position and a closed position for moving the jaw members between a spaced-apart position and an approximated position. A ratchet mechanism includes first and second ratchet components configured to engage one another upon movement of the at least one handle to the closed position to retain the jaw members in the approximated position. A knife is selectively movable between a retracted position and an extended position, wherein the knife extends between the jaw members to cut tissue therebetween. A safety mechanism is configured to inhibit extension of the knife when the jaw members are disposed in the spaced-apart position. Movement of the ratchet components into engagement with one another to retain the jaw members in the approximated position disengages the safety mechanism, thereby permitting extension of the knife.

A forceps includes first and second shaft members each having a jaw member disposed at a distal end thereof. One (or both) of the first and second jaw members is moveable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. The first jaw member includes a jaw frame fixedly engaged to the first shaft member and a disposable jaw housing releasably engageable with the jaw frame. The disposable jaw housing includes a knife assembly disposed therein. The knife assembly includes a knife blade biased toward an initial position, wherein the knife blade is disposed within the jaw housing. The knife blade is moveable between the initial position and an extended position, wherein the knife blade extends at least partially from the jaw housing to cut tissue grasped between the first and second jaw members.

A system for occluding a physical anomaly. One embodiment comprises a shape memory material body wherein the shape memory material body fits within the physical anomaly occluding the physical anomaly. The shape memory material body has a primary shape for occluding the physical anomaly and a secondary shape for being positioned in the physical anomaly.

A biodegradable device for maintaining the alignment of the edges of a trocar defect, consisting of two bases joined by a connector, a first base to be positioned below the defect and a second base above. The first base has a threaded hole from its upper surface but not through the lower surface. The connector attached to the bases such that there is a hole aligned with the threaded hole in the first base allowing a device to mate with the threads in the first base. The second base has a hole aligned with the hole in the connector and wide enough to allow a device to mate with the threads in the first base. The device is arranged so the distance between the lower surface of the second base and upper surface of the first base holds but does not compress the fascia around the trocar defect.

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture.

Methods and devices for ophthalmic tissue closure and fixation of ophthalmic prostheses are provided. In accordance with some embodiments, devices for both grasping and clipping a plurality of ocular tissue and ocular prostheses are provided. Various device embodiments are provided for both malleable clips and delivery of normally closed clips (i.e. shape memory). The device may accommodate a plurality of clips which include, but are not limited to: malleable metals, absorbable, shape memory, drug-eluting, and adhesive dispensing. The clips may be pigmented to match the colors of associated tissue (cornea, iris, conjunctiva, sclera, retina) to serve to camouflage fixation clips for healing duration or permanently. According to one aspect, shallow angle access to anatomy may be provided by specialized angulation of device shaft and closure jaws that are intended to access the eye through a small self-healing cornea incision and/or any ocular tissue.

A suture anchor comprising a one piece blank folded to form a body. The body has a floor, a first sidewall extending from one end of the floor and a second sidewall extending from an opposite end of the floor. A recess is defined by the floor, first sidewall and second sidewall. A crossbar extends inwardly from the second sidewall across the recess such that a free end of the crossbar is normally disposed distally of a transverse edge of the body. The crossbar is flexible such that when a distally directed force is applied, the free end of the crossbar is positionable in the recess. The free end of the crossbar is engageable with the transverse edge to limit the proximal motion of the crossbar from a proximally directed force.

A device for deploying a tissue fixation apparatus of the type including first and second tissue anchors coupled together by an adjustable suture assembly. The device comprises a handle mechanism and a needle cartridge assembly releasably coupled to the handle mechanism. The needle cartridge assembly includes a needle cannula with a side opening through which a tissue anchor can be loaded into an internal chamber of the needle cannula. A push rod is disposed in the needle cannula and is operable between an extended position in which the push rod prevents the tissue anchor from entering the chamber through the side opening, and a retracted configuration in which the tissue anchor can be pushed into the chamber under the action of a resilient band positioned over the side opening.

Embodiments of the invention relate generally to tissue anchors and methods of delivering same to the intervertebral disc or other sites within the body. In some embodiments, the anchors provide pull-out resistance, stability and/or maximize contact with tissue involving a minimum amount of penetration. In some embodiments, delivery methods are minimally invasive and include linear, lateral, and off-angle implantation or driving of anchors along, against or within tissue surfaces.

Devices, systems and methods for dynamically stabilizing the spine are provided. The devices include an expandable spacer having an undeployed configuration and a deployed configuration, wherein the spacer has axial and radial dimensions for positioning between the spinous processes of adjacent vertebrae. The systems include one or more spacers and a mechanical actuation means for delivering and deploying the spacer. The methods involve the implantation of one or more spacers within the interspinous space.

The sacral-iliac joint between an iliac and a sacrum is fused either by the creation of a lateral insertion path laterally through the ilium, through the sacral-iliac joint, and into the sacrum, or by the creation of a postero-lateral insertion path entering from a posterior iliac spine of an ilium, angling through the sacral-iliac joint, and terminating in the sacral alae. A bone fixation implant is inserted through the insertion path and anchored in the interior region of the sacrum or sacral alea to fixate the sacral-iliac joint.

A variable angle locking washer comprising a body having an outer surface circumferentially disposed between a top surface and a bottom surface, a central bore extending between the top and bottom surfaces, the central bore having a threaded portion and an unthreaded portion, and a plurality of radial slots peripherally positioned along the body, each slot defining a channel that extends between the outer surface of the body and the central bore.

A medical device for blood flow restoration and/or for use as an implantable member in a human vessel includes a self-expanding member, a guidewire, and a connection mechanism. The self-expanding member includes a plurality of cells and filaments having specific ranges of thicknesses, widths, and heights. The self-expanding member can take on a volume-reduced coiled form with overlapped edges, and can generate optimal radial forces against a vessel wall and/or thrombus when deployed and expanded.

An elongate inserter has a distal end releasably connected to an expandable interbody fusion device and a proximal end including a trigger actuator. The interbody fusion device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other in the intradiscal space. The inserter includes a lifting platform and an elevator that define cooperatively engaging ramps and ramps surfaces that upon operation of the trigger actuator cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert into the expanded device between the superior and inferior endplates.

An intervertebral fusion cage that is adapted to contain an inserter within its inner volume during insertion of the cage.

Various embodiments of intervertebral implants, anchoring devices for intervertebral implants, and implantation instrumentation are provided, along with various embodiments of methods for using one or more of the devices. Some embodiments of an anchoring device have a body comprising at least one curve and a rigid plate elongated along a longitudinal axis so that its front end enters at least one vertebra while its rear end remains in the passage of an implant. In some embodiments, the plate comprises at least one longitudinal slot separating at least one posterior portion of the plate into two branches, with at least one branch comprising at least one withdrawal stop configured to retain the device in the implant.

Various high-strength microwave antenna assemblies are described herein. The microwave antenna has a radiating portion connected by a feedline to a power generating source, e.g., a generator. The antenna is a dipole antenna with the distal end of the radiating portion being tapered and terminating at a tip to allow for direct insertion into tissue. Antenna rigidity comes from placing distal and proximal radiating portions in a pre-stressed state, assembling them via threaded or overlapping joints, or fixedly attaching an inner conductor to the distal portion. The inner conductor is affixed to the distal portion by, e.g., welding, brazing, soldering, or by adhesives. A junction member made from a hard dielectric material, e.g., ceramic, can be placed between the two portions and can have uniform or non-uniform shapes to accommodate varying antenna designs. Electrical chokes may also be used to contain returning currents to the distal end of the antenna.

A medical device used in a medical robotic system has a conduit and an orientable tip. An optical fiber coupled to a laser source and/or a catheter coupled to one or more biomaterial sources extends through the conduit and tip so that the tip of the medical device may be robotically directed towards a target tissue for laser and/or biomaterial application as part of a medical procedure performed at a surgical site within a patient. A protective sheath covers the fiber as it extends through the conduit and tip. A first coupler adjustably secures at least the sheath to the medical device and a second coupler adjustably secures the fiber to at least the sheath. A similar dual coupler mechanism may be used to secure the sheathed catheter to the medical device.

According to an embodiment of the present invention, a system optimizes an information processing environment, and comprises at least one processor. The system collects information pertaining to operational behavior of the information processing environment and including a plurality of parameters. A neural network structure is established to associate the parameters to a desired operational performance characteristic for the information processing environment. The neural network structure is trained with the collected information from the information processing environment to produce a model for the information processing environment. The model is optimized to determine values for the parameters and the information processing environment is adjusted based on the determined parameter values to attain the desired operational performance of the information processing environment. Embodiments of the present invention further include a method and computer program product for optimizing an information processing environment in substantially the same manner described above.

The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of a spinal fixation procedure. A bone anchor is provided. The anchor can include a bone fastener. The bone fastener can include a head and a second end adapted to engage an anatomy. The bone fastener can extend along a longitudinal axis. The anchor can also include a coupling arrangement coupled to the head of the bone fastener so that the bone fastener is rotatable about the longitudinal axis to define a first plane of motion. The anchor can further include a saddle, which can be coupled to the coupling arrangement. The saddle can be movable relative to at least one of the bone fastener and the coupling arrangement to define a second plane of motion.

A device for delivering a percutaneous nephrostomy plug is provided. The device comprises a tubular member configured for insertion into a biological body. The device further comprises a handle coupled to a proximal end of the tubular member. The handle comprises a pusher element, an actuation element, and a transmission. The pusher element is disposed within the tubular member, and is configured to deliver a plug through a distal end of the tubular member. The transmission is coupled to the tubular member and the actuation element, and the transmission is configured to cause a retraction of the tubular member relative to the pusher element in response to a depression of the actuation element. A first depression of the actuation element toward the tubular member urges a partial exposure of the plug. A second depression of the actuation element urges a further exposure of the plug.

The present disclosure relates to a suture anchor inserter. The suture anchor inserter includes a handle having a proximal component, a central component coupled to the proximal component, and a distal component coupled to the proximal component and the central component, the central component capable of rotating relative to the proximal component; and a shaft comprising a proximal end and a distal end, the proximal end coupled to the handle. A method of inserting a suture anchor into bone is also disclosed.

In one implementation, a method is disclosed in which a lock sensing mode is entered for a robotic surgical instrument. In the lock sensing mode, the degrees of freedom of movement in the robotic surgical instrument are switchably reduced. Further in the lock sensing mode, one or more end effectors of the robotic surgical instrument are switchably clamped together in the robotic surgical instrument. An increased level of torque may also be applied to the end effectors to increase a gripping force applied by the one or more end effectors in response to the reduced degrees of freedom of movement in the robotic surgical instrument.

A cutting or scoring balloon (26) is provided with a plurality of cutting or scoring elements (34) and is wrapped onto a balloon catheter (12) such that the cutting or scoring elements (34) overlie the balloon wall (36) with the balloon wall (36) pleated underneath the cutting or scoring elements (34). The cutting or scoring elements (34) remain exposed when the balloon (26) is pleated and wrapped onto the balloon catheter (12) and in a tightly wrapped configuration.

A substantially radiolucent cranial stabilization pin is adapted for use with a fixture for immobilizing a patient's head during a medical procedure. The pin includes a tip and a body, which are secured together to form the pin. The tip and body are constructed from non-ferrous, non-magnetic materials that are biocompatible. The tip and body are safe for use with, and compatible with, imaging techniques including MR imaging and CT imaging. In some examples the tip is a titanium insert and the body is molded within and around at least a portion of the tip. In some versions, the tip includes a hollow portion and one or more openings providing access to the hollow portion. The molded body flows into and around portions of the tip creating a secure pin suitable to withstand torque and axial forces observed in use.

A microwave ablation system includes an energy source adapted to generate microwave energy and a power splitting device having an input adapted to connect to the energy source and a plurality of outputs. The plurality of outputs are configured to be coupled to a corresponding plurality of energy delivery devices. The power splitting device is configured to selectively divide energy provided from the energy source between the plurality of energy devices.

In one embodiment, a surgical instrument comprises an articulable harmonic waveguide. The articulable harmonic waveguide comprises a first drive section comprising a proximal end and a distal end. The proximal end of the first drive section may be configured to connect to an ultrasonic transducer. The articulable harmonic waveguide further comprises a first flexible waveguide coupled to the distal end of the first drive section. An end effector extends distally from the first flexible waveguide. The surgical instrument further comprises an articulation actuator to flex the first flexible waveguide.

An anterior cervical plate system is provided. The cervical plate includes a retention ring with a deflectable flange that is upwardly spaced from the top surface of the ring and configured to prevent an inserted bone fastener from backing out of the plate. The plate includes a locking pin having a camming surface and a blocking surface. When the camming surface is moved into position adjacent to the flange, the flange is free to flex out of the way of a bone screw being inserted into or removed from the plate. When the blocking surface is positioned adjacent to the flange, outward deflection of the flange is prevented to retain the bone screw inside the plate. The locking pin is rotated through a camming surface to bring a blocking surface against the flange deflecting the flange onto the head of the bone screw.

The present invention is specifically directed to a heart occlusion device with a self-centering mechanism. The heart occlusion device includes two separate uniquely shaped wires 12, 14, each forming shapes that mirror the respective wire's shapes. Each wire forms half-discs or quarter-discs that together form a distal disc and a proximal disc. In other versions, the device includes four separate wires, each mirroring its neighboring wire and forming a proximal and a distal quarter-disc. In the versions with four wires, the quarter-discs of each wire together form proximal and distal discs. The distal disc and proximal disc are separated by a self-centering waist. The proximal disc is attached to a hub comprising a screw mechanism. A similar hub is optional on the distal disc. The discs further include coverings which form a sealant to occlude an aperture in a tissue. The wires forming the discs have a shape-memory capability such that they can be collapsed and distorted in a catheter during delivery but resume and maintain their intended shape after delivery.

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

An apparatus for insertion of a medical device in the skin of a subject is provided, as well as methods of inserting medical devices.

A data distributing and accessing method for sharing a file via a network system includes steps of: dividing the file into a plurality of blocks; distributing the blocks in a plurality of data hosts interconnected via the network system; one of the data hosts receiving a file-reading request from a user host and issuing collecting requests to other data hosts to collect the blocks from the data hosts; and transferring the collected blocks from the data hosts to the user host to be combined into the file.

A receiving device receives messages, detects the priority levels set in the headers of the messages, and reads the first and second messages. When the receiving device receives the header of the second message during reading of the first message, it controls, in accordance with the priority levels of the first and second messages, the reading rates at which the first and second messages are read.

A method of processing content according to a workflow, where a digital content is processed on one of a plurality of processing devices according to process definition associated to the content, includes the steps, iterated at the processing device, of: a) receiving from a server a signed workflow information, a workflow information comprising a status of the content processing, a signature of the process definition and a hash of the content;b) verifying the workflow information;c) when the workflow information is verified, processing the content according to the process definition and according to status of the content processing;d) updating and signing the workflow information;e) sending to the server the signed workflow information;and the steps iterated at the server of:f) receiving from a processing device a signed workflow information;g) publishing the signed workflow information received from the processing device. A system for performing the method is also provided.

A communication terminal that can adjust which section of a one-time pad cipher key is used and achieve cipher communication when there is a possibility that the one-time pad cipher keys are not completely matched between communication terminals. A cipher key transfer device acquires a one-time pad cipher key from a key sharing system, divides the acquired one-time pad cipher key with a predetermined number of bits, and transfers the same to a mobile communication terminal after converting the same into one-time pad cipher key cartridges. Along with the partner's terminal, the mobile communication terminal negotiates which one-time pad cipher key cartridge will be used to perform cipher communication, decides the one-time pad cipher key cartridge to be used, and begins cipher communication.

The invention relates to a method for configuring a mobile device capable of reproducing, for a user, multimedia content previously provided by a remote content server. The invention relates to using a client installed on said electronic device to relay authentication requests between a card, preferably complying with the provisions of the Mobile Commerce Extension standard, and an authentication server that is accessible via an access point.

Data is secured on a device in communication with a remote location using a password and content protection key. The device stores data encrypted using a content protection key, which itself may be stored in encrypted form using the password and a key encryption key. The remote location receives a public key from the device. The remote location uses the public key and a stored private key to generate a further public key. The further public key is sent to the device. The device uses the further public key to generate a key encryption key, which is then used to decrypt the encrypted content protection key. A new content encryption key may then be created.

An apparatus includes a logging apparatus and a configuration apparatus. The logging apparatus has a security module operable to create a manipulation-proof log. The configuration apparatus is operable to configure a configurable microprocessor system. The configuration apparatus is further operable to be coupled to the logging apparatus in order to log a configuration of the microprocessor system using the logging apparatus.

A method of authenticating a device involves establishing a local connection between a local target device and a local source device; at the source device, obtaining credentials of the target device via the local connection; at the source device, sending the credentials to a cloud authentication server via a secure communication channel; at the cloud authentication server, checking the credentials of the target device against a database of known good devices; at the source device, receiving a message from the cloud authentication server via the secure communication channel, said message indicating that the target device is authenticated; and delivering content from the source device to the target device on the condition that the target device is authenticated. This abstract is not to be considered limiting, since other embodiments may deviate from the features described in this abstract.