A system for excising an implanted clip approximating opposed valve leaflets in a heart valve includes a capture catheter configured to be introduced proximate the valve leaflets on one side of the clip, a transfer catheter configured to be introduced proximate the valve leaflets on another side of the clip, and a cutting tool configured to be deployed between the capture and transfer catheters and to be engaged against tissue of at least one of the valve leaflets and to excise the clip. A removal catheter may optionally be used to remove the clip from the heart.

Extraction devices for extracting chronically implanted devices such as leadless cardiac pacemakers (LCP). In some cases, the extraction devices may be configured to cut, tear or ablate through at least some of the tissue ingrowth around and/or over the chronically implanted device such that a retrieval feature on the chronically implanted device may be grasped for removal of the chronically implanted device. Implantable medical devices such as LCPs may include features that facilitate their removal.

A surgical cutting instrument (3) having a proximal end (4), a distal end (5), opposing sides (6, 7), and a longitudinal axis (8) and comprising: (i) an instrument body (2); (ii) a pivotal cutting arm (10) having a pinion (20) with an axis of rotation, the pinion being integrally formed with the pivotal cutting arm, wherein the pivotal cutting arm is mounted for rotation relative to the instrument body about a pivot axis (11), the pivot axis being the axis of rotation of the pinion, so that, rotation of the pinion about the pivot axis, causes the pivot arm to pivot relative to the instrument body; (iii) a cutting blade (40) on the pivotal cutting arm for resecting tissue; (iv) a rack (25) that can be moved in a reciprocating linear motion forward towards the distal end and rearwards toward the proximal end, the rack and the pinion being meshed together to forming a rack and pinion mechanism so that linear motion of the rack effects pivotal movement of the pivotal cutting arm about the pivot axis. This provides a very simple yet robust device which can have a minimum cross-section. It can thus be used for minimally invasive procedures such as cutting material from the interior of a spinal disc.

Methods and apparatuses for performing an orthopedic procedure in the sacroiliac region are disclosed. In one form, an aperture is formed that at least partially extends through at least one of an ilium and a sacrum. An undercutting system is inserted into the aperture. The undercutting system may include an insertion apparatus, a probe assembly, and a cutting assembly. The probe assembly is moved with respect to the insertion apparatus from a retracted position to an extended position. The probe assembly is manipulated within a joint between the ilium and the sacrum while the probe assembly is in the extended position. The cutting assembly is moved with respect to the insertion apparatus from a retracted position to an extended position. The cutting assembly is manipulated within the joint between the ilium and the sacrum while the cutting assembly is in the extended position to form a fusion region.

Methods and devices for blunt dissection include a differential dissecting instrument (DDI) comprising a rotary drive train having a distal end configured to be pointed substantially at a complex tissue and a proximal end pointed substantially at, and associated with, a mounting base. The DDI comprises a drive wheel possessing an axis of wheel rotation coaxial with a central, longitudinal axis of the rotary drive train, the drive wheel located distally to, and rotated by, the rotary drive train. The drive wheel comprises a drive point located at a non-zero radius from the axis of wheel rotation. The DDI also comprises a differential dissecting member rotatably mounted distally to the drive wheel and having an axis of member rotational oscillation.

An exemplary surgical device includes a shaft with a lumen defined therethrough and an element movable from a stored position to a deployed position in which a larger portion of the element extends out of the distal end of the lumen; wherein motion from the stored position to the deployed position causes a first leg of the element to advance distally relative to the distal end of the shaft, and causes a second leg of the element to move proximally relative to the distal end of the shaft.

Exemplary medical devices may include a snare device. The snare device may include a first leg having a proximalmost end and a second leg having a proximalmost end. The first leg and the second leg may form a distal loop. The proximalmost end of first leg may be independently moveable relative to the proximalmost end of the second leg.

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 differential dissecting instrument for differentially dissecting complex tissue is disclosed. The differential dissecting instrument comprises a handle and an elongate member having a first end and a second end, wherein the first end is connected to the handle. The differential dissecting instrument comprises a differential dissecting member configured to be rotatably attached to the second end and further comprises at least one tissue engaging surface. The differential dissecting instrument comprises a mechanism configured to mechanically rotate the differential dissecting member around an axis of rotation, thereby causing the at least one tissue engaging surface to move in at least one direction against the complex tissue. The at least one tissue engaging surface is configured to selectively engage the complex tissue such that the at least one tissue engaging surface disrupts at least one soft tissue in the complex tissue, but does not disrupt firm tissue in the complex tissue.

Extraction devices for extracting chronically implanted devices such as leadless cardiac pacemakers (LCP). In some cases, the extraction devices may be configured to cut, tear or ablate through at least some of the tissue ingrowth around and/or over the chronically implanted device such that a retrieval feature on the chronically implanted device may be grasped for removal of the chronically implanted device. Implantable medical devices such as LCPs may include features that facilitate their removal.