An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

The invention relates to a sealing device for repair of cardiac and vascular defects or tissue opening such as a patent foramen ovale (PFO) or shunt in the heart, the vascular system, etc. and particularly provides an occluder device and trans-catheter occluder delivery system. The sealing device would have improved conformity to heart anatomy and be easily deployed, repositioned, and retrieved at the opening site.

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

Embodiments for crossing an occlusion by controlling a guide with the aid of optical coherence tomography (OCT) data are described. Embodiments include transmitting one or more beams of radiation via one or more waveguides on a flexible substrate within a guide wire. One or more beams of scattered or reflected radiation may be received from a sample via one or more waveguides. Depth-resolved optical data of the sample may be generated based on the received beams of scattered or reflected radiation. The depth-resolved data may be used for determining at least one of a distance between the guide wire and a wall of the artery and a distance between the guide wire and an occlusion within the artery. A position of the guide wire within the artery may then be controlled based on the determined distance or distances.

Embodiments for crossing an occlusion by controlling a guide with the aid of optical coherence tomography (OCT) data are described. Embodiments include transmitting one or more beams of radiation via one or more waveguides on a flexible substrate within a guide wire. One or more beams of scattered or reflected radiation may be received from a sample via one or more waveguides. Depth-resolved optical data of the sample may be generated based on the received beams of scattered or reflected radiation. The depth-resolved data may be used for determining at least one of a distance between the guide wire and a wall of the artery and a distance between the guide wire and an occlusion within the artery. A position of the guide wire within the artery may then be controlled based on the determined distance or distances.

An ablation catheter system configured with a compact force sensor at a distal end for detection of contact forces exerted on an end effector. The force sensor includes fiber optics operatively coupled with reflecting members on a structural member. In one embodiment, the optical fibers and reflecting members cooperate with the deformable structure to provide a variable gap interferometer for sensing deformation of the structural member due to contact force. In another embodiment, a change in the intensity of the reflected light is detected to measure the deformation. The measured deformations are then used to compute a contact force vector. In some embodiments, the force sensor is configured to passively compensate for temperature changes that otherwise lead to erroneous force indications. In other embodiments, the system actively compensates for errant force indications caused by temperature changes by measuring certain local temperatures of the structural member.

Disclosed are devices and methods suitable for application of a curable fluid composition to a bodily organ, such as to a lower portion of a bodily organ. The device comprises a monolithic piece of material having a lower surface, two spaced-apart sides, and two spaced-apart walls connecting the two spaced-apart sides. A receptacle for containing the curable fluid composition is defined by the lower surface, the two sides, and the two walls. At least a portion of the height of the two walls is less than the height of at least a portion of the two sides. The device is deployable underneath the bodily organ such that a lower portion of the bodily organ is supported by at least a portion of each of the two walls.

An endoscope for removing tissue at a surgical site includes an elongated tubular body insertable within a mammalian cavity of a patient. An instrument channel extends between a first opening at a distal end and a second opening at a proximal end of the tubular body and is sized and configured to receive a surgical cutting assembly that includes an aspiration channel configured to remove material entering the endoscope via a distal end of the surgical cutting assembly. A torque generation component configured to generate torque is positioned within the distal end and configured to provide the generated torque to a coupling component. The coupling component is positioned at the distal end of the elongated tubular member and configured to actuate a cutting component of the surgical cutting assembly responsive to actuation of the torque generation component.

A surgical system includes a surgical instrument that is sensitive to backlash that would adversely affect the transmission of controlled torque and position to the surgical instrument. The surgical instrument is coupled to motors in a surgical instrument manipulator assembly via a mechanical interface. The combination of the mechanical interface and surgical instrument manipulator assembly have low backlash, e.g., less than 0.7 degrees. The backlash is controlled in the surgical instrument manipulator assembly. From the drive output disk in the surgical instrument manipulator assembly to the driven disk of the surgical instrument, the mechanical interface has zero backlash for torque levels used in surgical procedures.

An automated craniotomy opening apparatus includes a drilling apparatus with a drilling tip, at least one drilling apparatus positioning device, a detection device, and a computer processor that automatically controls the drilling apparatus, the positioning device, and the detection device. A method for automated opening of craniotomies includes, under automatic control of a computer processor, drilling into a skull for a predetermined distance and determining when there is a conductance drop near the drilling tip that indicates skull breakthrough. If the conductance is not below a predetermined threshold, drilling continues iteratively manner until conductance is below the threshold. A craniotomy pattern may be predetermined and automatically drilled under control of the processor. A cranial window may be created by drilling along a path that interpolates between holes to form the circumference of the window. Determining conductance may include use of an impedance detection circuit.