A surgical tunneler assembly is used to pass a cable or other elongate member through the skin. A surgical tunneler may include a lance including a first segment, a second end segment, and a connector on each one of the first end segment and the second end segment. A cable adapter includes a lance connection portion and a cable connection portion. The lance connection portion engages and disengages the connectors. The cable connection portion engages and disengages a cable. A handle engages and disengages the lance.

A bipolar tunneling tool is configured to separate tissue adhesions and tunnel. The bipolar tunneling tool includes a handle, a tunneling shaft, a return electrode, an optical window, an active electrode, and an insulative housing. The tunneling shaft extends from the handle. The return electrode is disposed proximate a distal end of the tunneling shaft. The optical window is disposed proximate the distal end of the tunneling shaft, the optical window defining a channel. The active electrode is at least partially disposed within the channel. The active electrode is configured to dissect a tissue and cauterize the tissue. The insulative housing is configured to electrically insulate the active electrode from the return electrode.

Implant tools and techniques for implantation of a medical lead, catheter or other implantable component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in implant locations such as substernal spaces or subcutaneous locations. The implant tools include a sheath coupled to a sealing device. The sheath includes a continuous lumen that is in fluid communication with a passage of the sealing device. The lead is advanced through the passage and the lumen for placement of the distal end of the lead at the implant location.

A method for fusing two adjacent stacked bones includes the following. First, inserting first and second pins into first and second locations of a first surface of one of the two adjacent stacked bones, respectively. Next, inserting a dilator over each of the first and second pins to dilate tissue around the first and second pins. Next, inserting a tissue protector over the dilator and removing the dilator. Next, inserting a cannulated drill through the tissue protector over each of the first and second pins and drilling first and second openings in the first and second locations, respectively, wherein the first and second opening extend through the two adjacent stacked bones. Next, tapping threads in the first opening and inserting a first bone fusing implant in the first opening, wherein the first bone fusing implant comprises threads configured to engage the threads of the first opening. Next, impacting a broach into the second opening to generate a pattern corresponding to a pattern of a second bone fusing implant and then inserting the second bone fusing implant in the second opening.

Tunneling tools and systems comprising electrodes and tunneling tool. In some examples the tunneling tools have a width that is greater than thickness, or may have enlarged portions to allow tunneling of a space. The tunneling tools may have expandable dissection portions including expandable balloons, linkages and/or springs in different examples. Systems may include tunneling tools with a lumen for receiving a lead having an electrode in a collapsed configuration, where the electrode is designed to expand once placed in a patient, with the tunneling tool designed to create a space in which the electrode can expand.

A kit for removing an embedded wire from tissue includes a dissector instrument for dissecting tissue surrounding an embedded wire and a pulling instrument for pulling the embedded wire from the tissue. The dissector instrument includes a proximal portion with a first and second handle and a distal portion. The distal portion of the dissector instrument includes a tubular section for surrounding an embedded wire. The pulling instrument includes a proximal portion with a first and second handle and a distal portion. The distal portion of the pulling instrument includes an elongated clamp for coupling to the embedded wire for extraction. The dissector instrument and pulling instrument may be used together as a kit, or separately to extract embedded wire from tissue.

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 includes an elongated outer sheath and an elongated inner sheath coaxially disposed within the outer sheath. The elongated outer sheath includes an outer sheath wall extending circumferentially about a longitudinal axis of the outer sheath to an extent greater than 180° and less than 360° to define an outer sheath slot. The elongated inner sheath includes an inner sheath wall extending circumferentially about a longitudinal axis of the inner sheath to an extent greater than the difference between 360° and the circumferential extent of the outer sheath wall, and less than 360° to define an inner sheath slot. The inner sheath is rotatable relative to the outer sheath to form an enclosed lumen when the outer and inner sheath slots are not aligned, and to form an open slot along the entire length of the introducer sheath when the outer and inner sheath slots are aligned.

A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

A method for optimizing the stimulation of the dorsal column of the spinal cord is disclosed. The method includes providing a stimulating electrode array and a frame element. The frame element is configured to couple to the stimulating electrode array and guide the stimulating electrode array to a desired position proximate the dorsal column of the spinal cord of a subject.