A lateral retractor system for forming a pathway to a patient's intervertebral disc space includes a single dilator and a retractable dual-tapered-blade assembly. The dilator may feature a narrow rectangular body for insertion at an insertion orientation parallel to the fibers of the patient's psoas muscle, at an approximate 45-degree angle to the patient's spine. The retractable dual-tapered-blade assembly consists of only two blade subassemblies, each having a blade bordered by adjustable wings, along with built-in lighting and video capabilities. The dual-tapered-blade assembly may be passed over the single dilator at the insertion orientation and rotated approximately 45-50 degrees to a final rotated orientation parallel to the intervertebral disc space before the two blade subassemblies are retracted away from one another to create the surgical pathway, while simultaneously and continuously assessing for encroachment upon one or more nerve structures within 360-degrees of the instrument. Other embodiments are also disclosed.

Embodiments of the invention provide an energy conveying structure for delivering RF and/or microwave energy to an electrosurgical instrument, where the energy conveying structure is incorporated into an insertion tube of a surgical scoping device (e.g. endoscope, laparoscope or the like). The insertion tube is a flexible conduit that is introduced into a patient's body during an invasive procedure, and can include an instrument channel and an optical channel. The energy conveying structure may be a layered coaxial structure that formed a liner that fits within the scoping device, e.g. within an instrument channel. Alternatively, the energy conveying structure may be a coaxial structure integrally formed as part of the flexible conduit.

A needlescopic scissors end effector assembly includes a pair of jaws or blades pivotable to perform a cutting or shearing operation. The scissors end effector assembly includes a cannula having a diameter between about 1 mm to 5 mm and a needle tip configured for percutaneous operation. The pair of jaws or blades includes cam profile surfaces to interact with an opening defined with the needle tip to actuate opening and closing of the pair of jaws or blades and to prevent backlash effect during the opening and closing of the pair of jaws or blades.

A surgical instrument includes a shaft, an ultrasonic transducer, a waveguide acoustically coupled with the ultrasonic transducer and extending distally through the shaft, and an end effector arranged at a distal end of the shaft. The end effector includes an ultrasonic blade acoustically coupled with the waveguide, a clamp arm movable relative to the ultrasonic blade for clamping tissue, and an RF electrode operable to seal tissue with RF energy. The ultrasonic transducer is operable to drive the waveguide and the ultrasonic blade with ultrasonic energy. The surgical instrument further includes an ultrasonic electrical circuit operable to energize the ultrasonic transducer, and an RF electrical circuit operable to deliver RF energy to the RF electrode. A return path of the ultrasonic electrical circuit and a return path of the RF electrical circuit pass through a shared electrically conductive element.

Disclosed herein are ultrasound transducers that are selectively insulated to thereby enable the transducers to be exposed to an electrically conductive fluid without causing a short circuit between electrodes of the transducers. Such a transducer includes a piezoelectric transducer body having a first surface and a second surface that are spaced apart from one another and do not intersect with one another. The ultrasound transducer also includes a first electrode disposed on the first surface, a second electrode disposed on the second surface, and an electrical insulator covering only one of first and second electrodes and configured to inhibit electrical conduction between the first electrode and the second electrode when the ultrasound transducer is placed within an electrically conductive fluid. Also disclosed are apparatuses and systems that include such a transducer. Related methods are also disclosed herein.

A compact ultrasonic transducer for an ultrasonic surgical instrument includes a proximal casing defining a hollow interior and a piezoelectric rod array including a plurality of piezoelectric rods radially spaced-apart from one another and arranged in a longitudinally-oriented direction. The piezoelectric rod array is disposed within the hollow interior. The compact ultrasonic transducer further includes a distal horn including a distal connector configured to engage a waveguide. The distal horn is configured to engage the proximal casing to enclose the piezoelectric rod array within the hollow interior. An ultrasonic surgical instrument including the compact ultrasonic transducer is also provided.

A medical device configured to perform an endovascular therapy can include an elongate manipulation member and an intervention member. The elongate manipulation member can include a distal end portion. The intervention member can include a proximal end portion and a mesh. The proximal end portion can be coupled with the distal end portion of the elongate manipulation member. The mesh can have a plurality of cells in a tubular configuration and being compressible to a collapsed configuration for delivery to an endovascular treatment site through a catheter and being self-expandable from the collapsed configuration to an expanded configuration. The mesh can include an anodic metal and a cathodic metal. The anodic metal and the cathodic metal can each form a fraction of a total surface area of the mesh.

A dual-motion rotation and retraction system for forming a pathway to a patient's intervertebral disc space includes a dilator, retractable dual-blade assembly, and dual-motion retractor. The dilator may feature a narrow rectangular, elliptical, or elongated configuration body for insertion parallel to the fibers of the psoas muscle, including an angle of 0 to 90 degrees to the patient's spine. The dual-blade assembly includes opposing blade subassemblies, each having a blade bordered by adjustable wings, along with built-in lighting and video capabilities. The dual-blade assembly may be passed over the dilator at the insertion orientation. The dual-motion retractor may be disposed about the dual-blade assembly and dilator and employed to both rotate the dual-blade assembly and the dilator 0 to 90 degrees to a final rotated orientation parallel to the intervertebral disc space and to retract the opposing blade subassemblies away from one another to create the surgical pathway. Other embodiments are also disclosed.

The present technology is directed to adjustable interatrial shunting systems that selectively control blood flow between the left atrium and the right atrium of a patient. The adjustable interatrial devices include a shunting element having an outer surface configured to engage native tissue and an inner surface defining a lumen that enables blood to flow from the left atrium to the right atrium when the system is deployed across the septal wall. The systems can include an actuation assembly for selectively adjusting a geometry of the lumen and/or a geometry of a lumen orifice to control the flow of blood through the lumen.

A surgical instrument with insulating grips is described. The grips can include internal metal frames that are arranged to limit electrical conductivity within the grips and to other components that attach to a grip, such as a ratchet. The internal metal frames can be constructed of multiple internal portions, spatially separated from one another to interrupt electrical conductivity between the internal portions, but coated with an insulating overmold to provide mechanical coupling between the portions. An internal metal frame can also include a notch, cut-out, or other region partially surrounded by the structure of the internal metal frame, which can be coated with an insulating overmold to define a region of the grip that does not have an internal metal frame therein but which can include an attachment point for mechanically coupling other components while limiting electrical coupling between the metal frame and the other components.