Disclosed herein are power modules and methods for insertion of a cannulated bone anchor and a stylet. Power modules disclosed herein are configured to adjustably control insertion of a bone anchor and a stylet under power from a motor. In certain embodiments, the motor may be included in a power hand piece. The power modules disclosed herein may be further configured to releasably couple a power hand piece to a driver for insertion of the bone anchor and stylet into the bone of a subject.

Various medical devices are described herein. More particularly, various probes used for performing lithotripsy and methods of performing lithotripsy are described. In an example, a probe comprises an elongate member comprising a proximal end, a distal end, a proximal portion, an intermediate portion, and a distal portion. The proximal portion has an outer diameter that is greater than the outer diameter of the distal portion.

A guidewire manipulation device includes a housing configured to be supported by the hand of a user, the housing having a distal end and a proximal end, the housing configured to allow a guidewire to be placed therethrough and extend between the distal end and proximal end, a drive system carried by the housing and configured to drive rotation of the guidewire, and a manual input module carried by the housing, the manual input module configured to allow one or more fingers of the hand of the user to manually stop or slow the rotation of the guidewire while the housing is supported by the hand of the user.

An apparatus including a sterilizable tray having a base and at least one fixture connected to the tray adapted for removably securing an implant insertion device to the tray. The tray can be free of a first wall portion for permitting the proximal end of an implantable device to axially align with the end of the implant insertion device for coupling to the implant insertion device and can be free of a second wall portion for permitting a tool to axially align with the end of the implant insertion device so as to threadedly couple the implant insertion device to the implantable device. Related methods and apparatus are provided.

Surgical instruments and methods for delivering bone anchor assemblies into bone are disclosed herein. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. In general, a surgical instrument can include a handle assembly having an elongate shaft extending distally therefrom. The handle assembly can be configured to axially translate a carrier assembly that secures a stylet extending therethrough. Translation of the stylet can be made relative to a distal end of the elongate shaft. The surgical instruments can include various carrier assemblies for positioning the distal end of the stylet relative to the distal end of the elongate shaft based on a length of bone anchor to be installed by the surgical instrument.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular wire and a coupling. The coupling when in use transmits ultrasonic energy along the wire from an ultrasonic energy source to an active tip at a distal end of the wire. The coupling is arranged to couple the source to the wire at any of a plurality of discrete operational positions along the length of the wire for said transmission of ultrasonic energy to the active tip.

An adaptor for a robotic catheter system includes a body defining an opening configured to encompass an outer rotatable portion of hemostasis valve, the outer rotatable portion being rotatable within the opening. A distal end connector configured to engage a portion of the hemostasis valve and a proximal end connector configured to connect to an elongated medical device support track.

A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non-removably attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radio-opaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.

Described herein are various method of using a direct drive system to perform procedures at a distance. One exemplary method include tying a knot or suturing at a distance with a first and second end effector. The direct drive system can enable sufficient end effector dexterity, including the ability to control various degrees of freedom of end effector movement, and allow a user to perform complicated task at a distance. In one aspect the direct drive system includes flexible tools that permit access to surgical site via a natural orifice.

A tissue traction device includes a first needle connected to a distal end of a first thread; a second needle connected to a distal end of a second thread; an elongated main body connected to the first thread and extending between the first thread and the second thread, the main body including a first hole; and a tube disposed at a proximal end of the main body, wherein the second thread is inserted through the first hole to be advanceable and retractable at a position between the second needle and a distal end of the tube, and the tube and the second thread are configured to be relatively movable in a longitudinal direction of the tube.