An insertion tool for creating a subcutaneous pocket and implanting a device in the pocket. The tool may include a cannula extending from a handle, a dissector tip disposed at a distal end of the cannula, and a rod. The cannula and dissector tip may create the pocket. The cannula may include a passage and an opening into the passage, and the cannula may be disposed in the passage and move along the passage between a retracted position and an extended position. The rod and the cannula may be configured such that, when the rod is at the retracted position, the cannula holds the device in the passage, and as the cannula moves from the extended position to the retracted position, the rod forces the device through the opening at the distal end of the cannula, at least partially out of the cannula, and at least partially into the pocket.

A surgical device includes a handle body extending along a handle axis. The handle body is releasably engaged to a tunneling shaft extending along a shaft axis transverse to the handle axis. At least one tool is mounted to the handle body. Each tool includes a working end adapted to actuate an element of an implantable device.

This disclosure provides tools and implant techniques utilizing such tools to gain access to and implant a medical device, such as a medical electrical lead, within extravascular spaces. In one example, this disclosure provides a tool for creating a sub-sternal tunnel in a patient. The tool comprises a relatively straight guide member extending from a first end thereof to a second end thereof, a tunneling member extending from a first end thereof to a tip thereof, the tunneling member extending alongside and coplanar with the guide member, the first end of the tunneling member and the first end of the guide member being joined together, and a handle coupled to 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.

An introducer sheath assembly including an introducer sheath and a protective sheath. The introducer sheath includes a hub having a proximal end and a distal end, and a tubular sheath projecting from the distal end of the hub. The protective sheath has a proximal end and a distal end. The distal end of the protective sheath is attached to the hub adjacent to the proximal end of the hub. The protective sheath is configurable between an undeployed state wherein the proximal end of the protective sheath is adjacent to the hub, and a deployed state wherein the proximal end of the protective sheath is away from the hub.

The present disclosure is directed to devices, kits, and methods for treating lumbar spinal stenosis by at least partially decompressing a compressed nerve root. The method can include identifying the compressed nerve root and percutaneously accessing a region of a lamina located adjacent to the compressed nerve root. The method can also include forming a channel through the region of the lamina, wherein the channel can be formed medial to a lateral border of the lamina. Further, the method can include expanding the channel in a lateral direction.

An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has a flexible body that allows the clearing tool to deflect when entering the epidural space through a window in the vertebral bone and ligaments. The clearing tool is guided into the epidural space and to a target site by a guidewire present in the epidural space. Upon removal of the guidewire and clearing tool, the medical lead is inserted through the window and cleared epidural space until reaching the target site. The clearing tool may include a distal tip with a shape and size that aids in the clearing of the epidural space. The distal tip may be integral to the clearing tool or may be removable so as to allow for different sizes of the distal tip to be installed as needed.

Devices, systems, and methods for treating damaged or diseased valves are disclosed. A representative embodiment includes an elongated shaft having a longitudinal axis, a proximal portion, and a distal portion, and a dissection arm at the distal portion. The dissection arm can have a longitudinal axis and be moveable between a low-profile state and a deployed state. In the deployed state, a portion of the arm can flex outwardly away from the longitudinal axis of the shaft. The arm is configured to be deployed within a space within a vessel wall such that, as the arm moves from the low-profile state to the deployed state, the arm pushes against vessel wall tissue at a periphery of the space, thereby separating tissue at the periphery to form a dissection pocket having a predetermined shape.

Described is a needle for subcision procedures having a concave cutting tip comprising two or more cutting edges wherein the concave cutting tip is at the cutting end of a shaft of the needle and wherein a handle is disposed at an angle relative to the axis defined by the center of the shaft of the needle. The cutting edges may be sharp interior edges within the circumference of the needle.

A steerable system and methods for accessing bone. A control mechanism includes a handle configured to be detachably secured to a trocar. The handle includes a drive shaft coupled to a sliding shaft such that relative rotation is prevented and relative translation is permitted. A rod having a preformed bend is removably disposed within the cannula. The rod is prevented from rotating relative to the drive shaft such that a deflection plane of the preformed bend is predefined relative to each of the sliding shaft, the handle, and the trocar when the handle is coupled to the trocar. Rotating a sliding ring of the handle translates the drive shaft to advance the rod beyond the trocar such that the preformed bend extends laterally out of the trocar in the deflection plane. The rod may be removed from the cannula, and material may be injected through the cannula.