The Vertebra Pick Device represents a new instrument to bore pilot holes in vertebra pedicles while imaging the operation with an integrated endoscope. The pilot holes are bored to provide entry points for pedicle screws that serve as anchor points for spine stabilizing rods to treat several spine conditions. The device consists of a metal body that terminates in a tapered incision tip, an endoscope that runs inside said metal body, a handle to drive the device into pedicle boney tissue and a fiber optics bundle assembly that enters the device handle and is used to connect to imaging, illumination, irrigation and suction devices to enable the endoscopic functions of the device. The fiber optics bundle assembly connects to an imaging camera that provides an electrical signal to a monitor to view the operation in real time.

A catheter extraction tool has a head that can be placed in position to significantly surround a diameter of a catheter. The head is shaped to have a low enough profile above the catheter to allow the head to be slid down the catheter and into a subdermal region in which the catheter is subdermal with respect to a patient. The head of the catheter extraction tool is expanded sufficiently to slide the head over a catheter cuff located in the subdermal region. After the head of the catheter extraction tool slides over the catheter cuff, the head is contracted to engage the catheter so that a user can pull the catheter out of the patient using the catheter extraction tool.

A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

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 coracoid drill guide assembly includes a body having a cylindrical channel on each side of the body for receiving a drill guide sleeve. The sleeves of the assembly have a 1.4 mm inner diameter to guide a 1.3 mm (or smaller) K-wire through the sleeve. An aimer arm extends from the body at a non-intersecting angle with the drill sleeve. The assembly also has a self-locking ratchet mechanism to lock the sleeve in place once the assembly has been secured to bone.

Implant tools and techniques for implanting implantable medical leads or other implantable components in extracardiovascular locations, such as substernal locations, are described. In one example, the present application provides an implant tool for implanting a medical lead comprises a handle and a shaft. The shaft includes a proximal segment that is permanently coupled to the handle and a distal segment that is detachably coupled to the proximal segment. The distal segment includes a proximal end configured to couple to the proximal segment, a distal end, and a lumen extending an entire length of the distal segment from the proximal end to the distal end. In some instances, the implant tool may be part of a delivery system that includes a puncturing tool having a proximal end and a distal end, wherein the distal end is sharp, such as a syringe coupled to a needle.

Tools adapted to allow a fixation device to be applied near the distal end of an implantable lead, and methods for using such tools. Preparing the lead for implantation may be performed by placing a tool over a distal tip of the lead, moving a fixation device from the tool to the lead, and placing the fixation device the lead.

A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

Systems and methods for separating an object such as a pacing lead from a patient tissue involve a flexible and torqueable shaft having an internal lumen sized to receive the object, and a hard separating mechanism for separating the object from the tissue. Typically the shaft and separating mechanism are advanced along or toward the object, and the separating mechanism is contacted with the tissue. The shaft is rotated to effect separation between the object and the tissue. The systems and methods are well suited for use in cardiac pacing or defibrillator lead explant procedures.

A method of resecting entire layers of a digestive tract includes: an insertion step of inserting an endoscope into the digestive tract; an everting step performed after the insertion step, to suture mucosal layers located on both sides of a target region including a lesion, cover the target region with the mucosal layers, and evert a tract wall including the target region to a side of an abdominal cavity, in the digestive tract; and an incision step performed after the everting step, to position an incision tool between the target region and the mucosal layers to incise the tract wall around the lesion by the incision tool.