A method of atraumatically hydrodissecting and maintaining endothelial function and structure of a vascular target includes forming an incision in tissue proximate one end to realize an insertion space, inserting a distal end of a cannula and/or endoscope into the insertion space and while visualizing the vascular target, ejecting a hydrodissecting fluid from the distal end of the cannula and/or endoscope to substantially separate or dissect the vascular target from the surrounding tissue, while advancing the distal end through the space as it is enlarged by the hydrodissecting fluid, to a distal target end of the vascular target. The hydrodissecting fluid is formulated to minimize or prevent formation of microthrombi in the hydrodissected vascular target. The hydrodissecting fluid is a water-based vascular graft treatment solution and can include any of a balance salt solution, a metallic salt solution, such as Plasma-Lyte® A, a vascular graft treatment solution, such as Duragraft® solution, L-Arginine, aspirin and low molecular weight heparin.

A surgical appliance includes a pair of opposed prongs slideably disposed on an elongated locking track for retracting neurovascular and musculotendinous anatomical structures through an incision for affording access to deeper structures for inserting osteosynthesis hardware in the surgical treatment of a distal radius fracture or other surgical procedure. The prongs extend from retractors that traverse the locking track for opposed linear movement while recessed in a surgical working region accessible through an incision. The prongs terminate in curvatures defining a void that gather and engage the elongated anatomical structures on top of the skeletal members receiving the plate. The prongs draw back the tendons, blood vessels and nerve structures to allow unimpeded surgical access for manipulating and attaching skeletal and soft tissue members and/or appliances. The device retracts anatomical structures along a linear track for a fixed locking engagement maintaining a surgical gap without direct manual assistance.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

Described herein is conduit material that causes minimal inflammatory reaction, and serves as a structural guide for regenerating nerve tissue (e.g., axons). Thus, the invention is directed to methods of treating a nerve injury in an individual in need thereof. The methods employ an isolated, naturally occurring epineural sheath, and can be used, for example, to regenerate nerve tissue in an individual in need thereof. Also provided herein is a device for harvesting an epineural sheath.

Urethrotome dilators for dilating a urethral stricture, and methods for forming and using the same are disclosed. In some embodiments, the urethrotome dilator includes a first distal end with a dilating head, a second proximal end with a handle, and a stem for connecting the first end to the second end. The dilating head may have a first region, a second region, and a channel for receiving a guidewire. The first region of the dilating head may have a substantially conical surface, with a vertex at its distal end and a base at its proximal end. The second region may have a substantially flat surface and a blade for stretching tissue. The blade may be integrally formed within the second region and may extend from the flat surface. The top edge of the blade may be tapered and blunt, while the two opposing sides of the blade may be formed with sharp corners for cutting tissue.

An articulating instrument including a distal assembly having first and second configurations and intermediate configurations between them. At least one of the first and second configurations is substantially stable such that the distal assembly of the instrument has a tendency to remain in the stable configuration when placed in that configuration by a user of the instrument. Preferably, the distal assembly terminates in a distal tip unit defining at least one distal feature that is useful for manipulating tissue.

A dissecting device that includes a grasping section and a dissecting member. The grasping section has an insertion lumen that permits an imaging device to be positioned therein. The dissecting member is at the distal portion of the grasping section and is insertable into a living body and movable along a blood vessel to dissect tissue surrounding the blood vessel. The dissecting member includes a base part having a lumen that communicates with the insertion lumen and a dissecting section which extends distally from the base part. The dissecting section is configured to dissect the tissue in the living body when the dissecting member is moved along the blood vessel. The dissecting member includes a blood vessel guide passage that accepts a branch vessel branched from the blood vessel at the distal portion of the dissecting member and guides the branch vessel toward the base part.

Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.

A medical device including an elongate member having a proximal end, a distal end, and a lumen extending therebetween. The medical device may further include an end-effector disposed at the distal end of the elongate member. The end-effector may include a plurality of arms pivotally connected to one another, wherein each arm includes a tissue-contacting surface, a first portion of the tissue-contacting surface including a plurality of ridges configured to grasp tissue. Further, the tissue-contacting surface may include a channel oriented substantially parallel to a longitudinal axis of the medical device.

The object of the present invention is to provide an improved laparoscopic, surgical instrument, particularly though not exclusively for gynaecology and in particular for Laparoscopic Colposuspension. According to the invention there is provided a laparoscopic, surgical instrument having an elongate shank, a ball head on one end and an eye in the other end. The instrument is such that the ball head is of a larger diameter than that of the elongate shank.