3114results about "External osteosynthesis" patented technology

A surgical instrument particularly suited to endoscopic articulates an end effector by including an end effector having a geared articulation mechanism that converts rotational motion from a handle portion. A hollow articulation drive tube transfers the rotation motion in some versions to a spear gear, bevel gear or snaggle tooth gear articulation mechanism. Alternatively, one or more threaded drive rod offset from a longitudinal axis engages a worm gear or flex-neck articulation mechanism.

A surgical instrument including a housing, an endoscopic portion, a shaft portion and an end effector is disclosed. The endoscopic portion extends distally from the housing and defines a longitudinal axis. The shaft portion is selectively connectable to a distal end of the endoscopic portion. The end effector is selectively connectable to a distal end of the shaft portion.

Circular stapling instruments for cutting and applying one or more surgical staples to tissue are disclosed. The instruments include various forms of feedback systems designed to provide at least one mode of feedback to the surgeon when the knife has cut through tissue clamped between a staple cartridge and an anvil portion.

A surgical staple line reinforcement is provided for use with a variety of surgical staplers to protect against tissue damage from surgical staples. The surgical staple line reinforcement is made up of a tubular structure of bio-implantable material with one or more stiffening members attached to or integrated within the tubular structure to resist, prevent or inhibit movement, rotation, or longitudinal compression of the tubular structure.

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

A safety handle assembly for use with a surgical instrument having an operative distal end portion is disclosed. The handle assembly includes a handle housing and a drive element movably mounted within the handle housing and connected to an associated operative distal end portion. A drive assembly is positioned within the handle housing and is engageable with the drive element to move the drive element within the handle housing. An actuator is movably mounted on the handle housing and an adjustable force-limiting mechanism is interposed between the drive assembly and the actuator. A force-limiting mechanism releasably connects the actuator to the drive assembly. The force-limiting mechanism is adjustable to preset the force at which the actuator separates or breaks away from the drive assembly.

Methods and apparatus for forming one or more trans-sacral axial instrumentation / fusion (TASIF) axial bore through vertebral bodies in general alignment with a visualized, anterior or posterior axial instrumentation / fusion line (AAIFL or PAIFL) in a minimally invasive, low trauma, manner and providing a therapy to the spine employing the axial bore. Anterior or posterior starting positions aligned with the AAIFL or PAIFL are accessed through respective anterior and posterior tracts. Curved or relatively straight anterior and curved posterior TASIF axial bores are formed from the anterior and posterior starting positions. The therapies performed through the TASIF axial bores include discoscopy, full and partial discectomy, vertebroplasty, balloon-assisted vertebroplasty, drug delivery, electrical stimulation and various forms of spinal disc cavity augmentation, spinal disc replacement, fusion of spinal motion segments and implantation of radioactive seeds. Axial spinal implants and bone growth materials can be placed into single or multiple parallel or diverging TASIF axial bores to fuse two or more vertebrae, or distract or shock absorb two or more vertebrae.

A surgical staple, comprising a backspan, a first leg member extending from the backspan, a second leg member extending from the backspan, and at least one substantially continuous channel extending along at least one of an inner surface and an outer surface of the first leg member and the second leg member.

A medical manipulator system includes a manipulator, an operating unit for entering operation commands, motors for actuating a working unit, and a controller for energizing the motors based on operation commands supplied from the operating unit. When an activation resetting switch and a resetting switch are operated according to a predetermined procedure, the controller performs a resetting process to return the motors to an origin. The controller is capable of controlling three manipulators. The activation resetting switch is shared by the three manipulators, and there are three resetting switches corresponding to the three manipulators.

A surgical cutting and fastening instrument that includes an elongate channel that is attached to a handle assembly by an elongate shaft assembly. The elongate channel is configured to receive a cartridge and has a pivotally translatable anvil attached thereto and a knife bar supported therein. The anvil may be selectively opened and closed by manipulating a closure trigger supported by the handle assembly. The knife bar may be distally advanced through the elongate channel by actuating a firing trigger that cooperates with a reversible rotary drive supported by the handle assembly. The knife bar may also be retracted to its starting position by actuating the firing trigger after the reversible rotary drive has been shifted to a retraction orientation.

An endoscopic instrument comprises a shaft, comprising a proximal end and a distal end. A grip comprising a handle is arranged at said proximal end of said shaft and a tool having at least an open and a closed position is arranged at said distal end of said shaft. Said shaft comprises at least two sections, a first section and a second section, which can be articulated with respect to said first section. Said second section comprises said tool. Said instrument further comprises an actuating element, by means of which said handle is in operative connection with said second section and with which an articulation of said second section can be initiated. Said first section or said actuating element and said tool are connected by a control element, by means of which said tool can be moved back and forth between said closed position and said open position in the course of an articulation of said second section, such that both the articulation of said second section and an opening / closing of said tool can be accomplished by the movement of said actuating element.

A surgical cutting and fastening instrument is disclosed. According to various embodiments, the instrument includes an end effector, a main drive shaft assembly connected to the end effector, and a gear drive train connected to the main drive shaft assembly. The end effector comprises a movable cutting instrument for cutting an object positioned in the end effector. The instrument also includes a main motor for actuating the gear drive train and a firing trigger for actuating the main motor. The instrument also includes a tactile position feedback system for applying force to the firing trigger such that the position of the firing trigger is related to the position of the cutting instrument in the end effector.

An elastic or flexible element for use in a stabilization device for bones or vertebrae is provided. The elastic or flexible element is provided in the form of an essentially cylindrical body with a first end and a second end opposite thereto, wherein at least one of the opposite ends of the cylindrical body comprises a coaxial bore hole with an internal thread for connecting to a shaft and / or a head of a bone screw or for connecting to a rod section. The present invention further provides a bone anchoring element, e.g. a bone screw, with a shaft for the anchoring in a bone, whereby the shaft comprises an elastic or flexible section which is formed integrally with the shaft or as a separate elastic or flexible element. It is preferable for the elastic section to be implemented in the form of a helical spring. Moreover, the present invention provides a stabilization device for bones, for instance for vertebrae, said device comprising at least one bone anchoring element according to the invention, a second bone anchoring element and a rod or plate connecting the bone anchoring elements.

A rod-shaped implant element (1, 100, 101, 102, 300) is disclosed for the connection of bone anchoring elements, Each bone anchoring element has an anchoring section (12) to be anchored in the bone and a receiver member (13) to be connected to the rod-shaped implant element The rod-shaped implant element has at least one rigid section (7, 8) that is configured to be placed in the receiver member (13). It also has a flexible section (9, 90, 900, 902) that is adjacent to the rigid section. The flexible section and the rigid section are formed in one piece. Also disclosed is a stabilization apparatus using a rod-shaped implant element and at least two of the bone anchoring elements. The stabilization apparatus can limit the movement of two vertebrae or parts of a bone in relation to each other in a defined manner.

A powered surgical stapler is disclosed. The stapler includes a housing, an endoscopic portion extending distally from the housing and defining a first longitudinal axis, a drive motor disposed at least partially within a housing and a firing rod disposed in mechanical cooperation with the drive motor. The firing rod is rotatable by the motor about the first longitudinal axis extending therethrough. The stapler also includes an end effector disposed adjacent a distal portion of the endoscopic portion. The end effector is in mechanical cooperation with the firing rod so that the firing rod drives a surgical function of the end effector. The stapler further includes a control system having a plurality of sensors coupled to the drive motor, the firing rod, the loading unit and the end effector, the plurality of sensors configured to detect operating parameters thereof. The control system also includes a microcontroller coupled to the plurality of sensors and being configured to determine operating status of the powered surgical stapler as a function of the detected operating parameters.

A surgical instrument is disclosed. The surgical instrument has an end effector and a trigger in communication with the end effector. The surgical instrument also has a built-in memory system for recording the instrument condition during a use process. The recording system comprises: a first sensor located on or inside the instrument and an externally accessible built-in memory device in communication with the first sensor. The first sensor has an output that represents a first condition of either the trigger or the end effector. The memory device is configured to record the output of the first sensor. In various embodiments, memory device may include an output port and / or a removable storage medium.

An endoscopic instrument is provided and includes a housing including an elongated shaft assembly extending distally therefrom. The elongated shaft assembly includes inner and outer shaft members. The inner and outer shaft members are removably coupled to the housing and the outer shaft member is movable with respect to the inner shaft member. An end effector is operably supported at the distal end of the outer shaft member and includes a pair of jaw members configured for treating tissue. A bushing operably couples to the inner and outer shaft members of the shaft assembly and selectively and releasably couples to the housing. The bushing includes one or more mechanical interfaces configured to engage one or more slots defined through the inner shaft member and one or more slots defined through the outer shaft member to release the inner and outer shaft members from the housing.

One or more shaped axial bore extending from an accessed posterior or anterior target point are formed in the cephalad direction through vertebral bodies and intervening discs, if present, in general alignment with a visualized, trans-sacral axial instrumentation / fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation / fusion line (AAIFL) or a posterior axial instrumentation / fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment. Preferably, curved anterior or posterior TASIF axial bores are formed in axial or parallel or diverging alignment with the visualized AAIFL or PAIFL, respectively, employing bore forming tools that can be manipulated from proximal portions thereof that are located outside the patient's body to adjust the curvature of the anterior or posterior TASIF axial bores as they are formed in the cephalad direction. Further bore enlarging tools are employed to enlarge one or more selected section of the anterior or posterior TASIF axial bore(s), e.g., the cephalad bore end or a disc space, so as to provide a recess therein that can be employed for various purposes, e.g., to provide anchoring surfaces for spinal implants inserted into the anterior or posterior TASIF axial bore(s).

One or more curved axial bore is formed commencing from an anterior or posterior sacral target point and cephalad through vertebral bodies in general alignment with a visualized, trans-sacral axial instrumentation / fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation / fusion line (AAIFL) or a posterior axial instrumentation / fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment. Generally curved anterior or posterior TASIF axial bores are formed in axial or parallel or diverging alignment with the visualized AAIFL or PAIFL, respectively. The anterior and posterior TASIF axial bore forming tools can be manipulated from proximal portions thereof to adjust the curvature of the anterior or posterior TASIF axial bores as they are formed in the cephalad direction. The boring angle of the distally disposed boring member or drill bit can be adjusted such that selected sections of the generally curved anterior or posterior TASIF axial bores can be made straight or relatively straight, and other sections thereof can be made curved to optimally traverse vertebral bodies and intervening disc, if present.

A self contained motor-powered disposable loading unit for use with a surgical cutting and stapling apparatus. The disposable loading unit may contain a battery that is retained in a disconnected position when the disposable loading unit is not in use and is moved to a connected position when the disposable loading unit is coupled to the surgical cutting and stapling apparatus to permit the motorto be selectively powered thereby. Indicators may be supported on the disposable loading unit to indicate when the axial drive assembly thereof is in a starting position and an ending position. Another indicator may be provided to indicate when the anvil assembly is in a closed position.

Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient's tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

An interface which allows a surgeon to operate multiple surgical devices from a single input device. The input device may be a foot pedal that provides output signals to actuate a number of different surgical devices. The surgical devices may include a robotic arm, a laser, an electrocautery device, or an operating table. The interface has an input channel that is coupled to the input device and a plurality of output channels that are coupled to the surgical devices. The interface also has a select input channel which can receive input commands to switch the input channel to one of the output channels. The select channel may be coupled to a speech interface that allows the surgeon to select one of the surgical devices with a voice command. The surgeon can operate any device by providing an input command which switches the input channel to the desired output channel.

Closure systems for applying a closure motion to an anvil assembly of a surgical instrument. In various embodiments, the surgical instrument includes a cable drive knife assembly and the anvil assembly thereof is moved to a closed position when contacted by a closure tube assembly that has a pushing force applied thereto. Other embodiments include closure systems that may be actuated by rotary motion. Various lockable articulation joints are also disclosed.

A medical implant deployment tool and deployment method are disclosed. One aspect of the invention provides an implant system including an implant adapted for endovascular delivery and deployment; and a deployment tool adapted to deploy the implant, with the deployment tool having an actuation controller; a plurality of actuation elements adapted to apply forces to one or more implant deployment mechanisms and each adapted to extend along an actuation element path within a patient's vasculature; and an actuation element compensation mechanism adapted to compensate for differences in length between the actuation element paths. Another aspect of the invention provides a method of deploying an implant including the steps of endovascularly delivering an implant and implant deployment mechanisms to an implant site and applying an actuation force to the implant deployment mechanisms through actuation elements extending through the patient's vasculature while compensating for differences in length between actuation element path lengths to deploy the implant.

A loading unit for use with a surgical stapling apparatus is provided and includes a tool assembly having a cartridge assembly and an anvil assembly that are movable in relation to one another; a surgical buttress releasably secured to a tissue contacting surface of the anvil assembly and / or the cartridge assembly, wherein each surgical buttress is secured to the anvil assembly and / or the cartridge assembly by at least one anchor; a release assembly associated with the anvil assembly and / or the cartridge assembly; and a drive assembly slidably translatable through the tool assembly between proximal and distal positions, wherein the drive assembly actuates the release assembly to thereby release the anchor to free the surgical buttress from the anvil assembly and / or the cartridge assembly.

The present invention includes a surgical stapler having a staple cartridge, an anvil, and a cutting member having a cutting surface, wherein the cutting member is relatively movable with respect to the anvil and the staple cartridge. In at least one embodiment, the anvil is movable between an open position and a partially-closed position. When the anvil is in its partially-closed position, the anvil and the staple cartridge can be configured to capture tissue therebetween without fully compressing the tissue. In at least one embodiment, the anvil includes a proximal portion, a distal portion, and a middle portion intermediate the proximal portion and the distal portion. In these embodiments, the tissue can be captured between the proximal and distal portions of the anvil before the middle portion of the anvil is brought into contact with the tissue.

A balloon for use in compressing cancellous bone and marrow (also known as medullary bone or trabecular bone). The balloon comprises an inflatable balloon body for insertion into said bone. The body has a shape and size to compress at least a portion of the cancellous bone to form a cavity in the cancellous bone and / or to restore the original position of the outer cortical bone, if fractured or collapsed. The balloon desirably incorporates restraints which inhibit the balloon from applying excessive pressure to various regions of the cortical bone. The wall or walls of the balloon are such that proper inflation of the balloon body is achieved to provide for optimum compression of the bone marrow. The balloon can be inserted quickly into a bone. The balloon can be made to have a suction catheter. The balloon can be used to form and / or enlarge a cavity or passage in a bone, especially in, but not limited to, vertebral bodies. Various additional embodiments facilitate directionally biasing the inflation of the balloon.

The present invention expands a spinal canal by drilling a cylindrical passage in each pedicle of a vertebra, making a circumferential pedicle cut (osteotomy) through each pedicle from within the passage, separating each pedicle cut by inserting an implant into the passage which distracts the pedicle cut to expand the spinal canal, and securing each pedicle cut, allowing the vertebra to heal with the spinal canal expanded. The implant includes an outer sleeve, an inner bolt, and expandable flanges. The outer sleeve includes an upper portion and a lower portion, with the expandable flanges connected to the lower portion and housed within the upper portion. Rotation of the inner bolt causes the upper and lower portions of the outer sleeve to separate, causing the pedicle cut to widen and the expandable flanges to radially extend into and stabilize the widened pedicle cut to effectuate expansion of the spinal canal.

A disposable loading unit for operable attachment to a surgical stapling apparatus. The disposable loading unit may have a carrier that supports a staple cartridge therein, an anvil assembly that is movably coupled to the carrier, and an axial drive assembly that is constructed to move in a distal direction from a start position to an end position through the staple cartridge in response to a drive motion imparted to the axial drive assembly from the surgical stapling apparatus. A firing indicator is provided on at least one of the anvil assembly and housing for indicating a position of the axial drive assembly as the axial drive assembly is driven from the start position to the end position.

Methods and apparatus for providing percutaneous access to vertebrae in alignment with a visualized, trans-sacral axial instrumentation / fusion (TASIF) line in a minimally invasive, low trauma, manner are disclosed. A number of related TASIF methods and surgical tool sets are provided by the present invention that are employed to form a percutaneous pathway from an anterior or posterior skin incision to a respective anterior or posterior target point of a sacral surface. The percutaneous pathway is generally axially aligned with an anterior or posterior axial instrumentation / fusion line extending from the respective anterior or posterior target point through at least one sacral vertebral body and one or more lumbar vertebral bodies in the cephalad direction. The provision of the percutaneous pathway described herein allows for the formation of the anterior or posterior TASIF bore(s) and / or the introduction of spinal implants and instruments.