A tissue dissector is provided. The tissue dissector includes an introducer including a lumen extending along a length thereof and defining a longitudinal axis therethrough. The introducer configured for placement adjacent target tissue. A shaft operably coupled to the introducer is deployable from a distal end thereof and includes a proximal end for approximating the distal end of the shaft adjacent target tissue. The distal end of the shaft is movable from a non-expanded configuration to an expanded configuration for separating target tissue from neighboring tissue.

A device for dividing a fibrous structure comprising a catheter; an expandable member positioned near a distal end of the catheter and in fluid communication with a lumen of the catheter; and a cutting element situated on an outer surface of the expandable member. A method for dividing a fibrous structure comprising positioning, proximate the fibrous structure, an expandable member having a cutting element situated thereon; expanding the expandable member outwards to tension the fibrous structure across the cutting element; and activating the cutting element to weaken or cut the fibrous structure. A method for treating carpal tunnel syndrome comprising inserting a needle into the carpal tunnel; directing a guidewire to a position proximate the transverse carpal ligament; advancing, along the guidewire, a device having an expandable member and a cutting element; positioning the cutting element; tensioning the ligament across the cutting element; and weakening or cutting the ligament.

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.

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.

The implantable nerve blocking intervention involves performing a first subdermal incision on the ventral lateral portion of the patient's thorax. A first end of a tunneling device is inserted through the first subdermal incision. The tunneling device is traversed below the patient's dermal layer towards the mid axillary line. The tunneling device is traversed above the lower section of the rib cage towards the patient's paralumbar line. A longitudinal paramidline incision is performed about 3 inches lateral to the vertebral body and the tunneling device. A needle or trocar tip is inserted through the paramidline incision towards a primitive cluster of nerves and a catheter is placed through the needle or trocar which is removed prior to anchoring the catheter. A catheter tube is inserted through the length of the tunneling device. The catheter tube is coupled to the distal catheter. The tunneling device is retracted over the catheter tube. The catheter tube is coupled to a percutaneous access port.

Aspects of the present disclosure are directed toward apparatuses, systems, and methods that comprise an introducer apparatus for facilitating subcutaneous implantation of a medical device. In certain instances, the apparatus may include a housing, an inserter configured to pass the medical device through the housing, and a tunneler configured to form a subcutaneous pocket for the medical device.

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 glaucoma treatment system includes a glaucoma drainage device having a flexible tube with distal and proximal ends, and an inserter with a filament that extends beyond the distal end of a rigid elongate member (e.g., rod or inserter tube). The filament is configured to detachably couple a distal portion of the drainage device tube to the elongate member of the inserter. The filament may extend through a wall of the distal portion of the drainage device tube. The filament and elongate member of the inserter can be configured for relative movement to detach the drainage device tube from the inserter. The elongate member can define an internal channel, and the filament can be configured for axial movement in this channel so that the filament may move toward the proximal end of the elongate member to detach the drainage device tube from the inserter. Other tools are described and claimed.

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.

Aspects of the present disclosure are directed toward apparatuses, systems, and methods that comprise an introducer apparatus for facilitating subcutaneous implantation of a medical device. In certain instances, the apparatus may include a housing, an inserter configured to pass the medical device through the housing, and a tunneler configured to form a subcutaneous pocket for the medical device.