A ligament fixation method can include forming a bone tunnel to a predetermined depth from a surface of a bone; mounting a reconstruction ligament to the ligament fixation device. The reconstruction ligament can be disposed along outer surfaces of plate-like pressing segments of a ligament fixation device and an outer surface of a connection segment that connects the pressing segments. The method can also include inserting the ligament fixation device into the bone tunnel from the connection-segment side; fastening a screw to a receiving section of the ligament fixation device from an opening of the ligament fixation device to increase a distance between the pair of pressing segments and to compress the reconstruction ligament between each pressing segment and an inner surface of the bone tunnel; and fixing the reconstruction ligament to the bone by causing a part of the screw to dig into the bone.

The present invention is a group of surgical instruments with improved function and design for dental and craniofacial surgery, especially subperiosteal tunneling and related procedures. The instruments include surgical elevators for vestibular incision or incisions in the gingival sulcus. The instruments have varying angles and shapes to create a mucosal tunnel in any oral or maxillofacial region. The instrument suite also optionally includes specially designed forceps for introduction of graft material inside the subperiosteal tunnel and to assist with suturing of the graft to surrounding tissue.

In some examples, a tool for, e.g., creating a sub-sternal tunnel in a patient or other use, is described. The tool may include a handle and a tunneling shaft coupled to the handle. The tunneling shaft extends from a proximal end to a distal end, and at least a portion of the tunneling shaft extends in a curved orientation between the first end to the distal end. The distal end of the tunneling shaft includes a cutting tool having a sharp edge. The cutting tool is moveable from a recessed position in which the sharp edge of the cutting tool is recessed into the distal end of the tunneling shaft to a deployed position in which the sharp edge of the cutting tool extends beyond the distal end of the tunneling shaft in the deployed position, e.g., to cut pericardium, scar tissue, and/or connective tissue with the sharp edge.

New methods for implanting a cardiac therapy system include implanting a lead of the system substernally anterior of the heart without attaching to the myocardium or pericardium. An illustration includes placement of an anchor beneath the sternum in the vicinity of one of the sternal angle, a location superior of the ventricles, the area bounded by the 2nd or 3rd ribs, and level with the aortic arch. A tension element or tether is attached to the anchor and a lead is introduced over the tension element or tether and secured in a desired position relative to the anchor. Other examples also include implantation, sub sternally, of a lead without the use of a pre-tunneling tool or sheath over the lead itself, for example by using an advancing tool for pushing the lead into position.

A method for operating an ultrasonic reentry device, includes: providing an ultrasound transmission member having a proximal end and a distal end; providing a catheter body having a lumen surrounding the ultrasound transmission member; providing a dilator slidably disposed within the lumen of the catheter body, the dilator surrounding the ultrasound transmission member; and exposing the distal end of the ultrasound transmission member from a distal end of the dilator.

A system and method are described herein for designating a precise location for a bone tunnel to receive a ligament or tendon graft and guiding a robotic drill for creating the bone tunnel. The system includes a tracking system, a digitizer, a computing system, and a robotic drill. The digitizer designates a start point for the tunnel entry site and an end point where the tunnel terminates. The start point and end point are recorded in the computing system and a vector is calculated between the start point and the end point. The vector is supplied to a robotic drill to drill the tunnel in the bone. A ligament or tendon graft may be placed in the tunnel and secured to the bone to complete the procedure.

Systems and methods for treating cellulite including an apparatus that applies or a method involving separating septa to eliminate or reduce the appearance of cellulite. In one approach, an interventional tool is placed between tissue layers to engage and treat septa connecting tissue layers between which fat deposits are contained.

A lead-implantation tool for implanting a lead into a patient includes an elongated body having a distal portion with a tip configured to separate patient tissue to form, or extend through, a tunnel in the tissue when the body is advanced along the tissue. A lead-retention element is formed along the distal portion of the body and includes a cutout defined along the body with a cutout surface wall inset from the body's outer surface. A protrusion extends outwardly from the cutout surface wall with at least a portion of the protrusion extending towards the tip. The protrusion is entirely inset from, or flush with, the body's outer surface. The protrusion is configured to removably receive and retain a portion of the lead while the distal portion of the body is advanced along the tissue and to separate from the lead as the body is withdrawn from the tissue.

A method of forming an access route to the bile duct includes: forming a tunnel extending from an oral ridge of a duodenal papilla, which is located on an oral side of a natural opening of a duodenal papilla, to the bile duct; and dilating a lumen of the tunnel more than when it was formed.

Methods and tool kits for implanting a lead subcutaneously. Examples include tool kits and methods for establishing first and second subcutaneous tunnels at an angle relative to one another to facilitate introduction of a lead to the subcutaneous space. In an example, a tunneling tool and lead assembly are advanced simultaneously into the subcutaneous space. The tunneling tool may include a curved region configured to transition the tool from the first subcutaneous tunnel to the second subcutaneous tunnel with the use of a single incision.