Optical spectroscopic devices, apparatus, systems and methods useable for physiological monitoring from intraosseous, subosseous, epidural, subdural, intraventricular, intramuscular, sub-adipose and other subcutaneous locations.

An apparatus for accessing bone marrow inside a bone is provided. The apparatus may include a penetrator assembly having a tissue penetrator and a hub. The tissue penetrator my have a hollow cannula disposed in fixed relation to the hub. The apparatus may also have a driver configured to insert a portion of the tissue penetrator into the bone and bone marrow, and a depth control mechanism configured to control the depth of penetration of the tissue penetrator into the bone and bone marrow. The depth control mechanism may have a sensor configured to detect a position of the bone and bone marrow. The depth control mechanism may also have a mechanical stop.

An articulating drill system is provided that includes a hand-held portion and a drill portion. At least two actuators are provided for controlling at least two axes of the drill portion. A navigation system is provided to control the at least two actuators. In some embodiments, a tool is provided with the drill portion and adapted to interact with patient tissue. The drill portion can be modified to include at least two rigid objects in communication with the actuators and attached to the drill portion. The system can be used to make any linear cut within a deviation of 1.0 mm and 1.0, or better in patient tissue.

An articulating drill system is provided that includes a hand-held portion and a drill portion. At least two actuators are provided for controlling at least two axes of the drill portion. A navigation system is provided to control the at least two actuators. In some embodiments, a tool is provided with the drill portion and adapted to interact with patient tissue. The drill portion can be modified to include at least two rigid objects in communication with the actuators and attached to the drill portion. The system can be used to make any linear cut within a deviation of 1.0 mm and 1.0?, or better in patient tissue.

This disclosure describes various tools and associated methods suitable for gaining access to extravascular spaces. The various tools and associated methods utilize a boring tip that may rotate to aid in safely and effectively crossing diaphragmatic attachments. The boring tip may, in some instances not have any sharp edge. For example, the boring tip may have a dome shape but including at least one surface recessed and offset from a summit of the dome shape. Various mechanisms may be used to control rotation of the boring tip as described herein.

A cutting device for cutting a patient's sternum includes a laser source adapted to generate a cut laser beam, a beam adjusting structure arranged for directing the cut laser beam generated by the laser source along a predefined cut geometry at the sternum, a support that carries the laser source and, optionally, a correction arrangement. The support has a mounting structure adapted to be fixed to a patient's rib cage such that the laser source is in a predefined position with respect to the sternum. The correction arrangement is adapted to automatically identify a movement of the laser source relative to the sternum causing the cut laser beam to deviate from the predefined cut geometry. It is further adapted to automatically adjust the position of the laser source relative to the sternum to correct the deviation of the cut laser beam with respect to the predefined cut geometry.

Provided is a surgical saw for cutting a sternum comprising: a) a body, b) a handle attached to the body; c) a blade positioned in such way to cut the sternum when a user holds the handle, and d) a base below the blade configured to be positioned below the sternum, wherein the user places the base under the sternum and cuts the sternum with the blade.

This disclosure describes various examples of multi-purpose tools and associated methods for safely gaining access to extravascular spaces. The multi-purpose tools described herein are particularly suited for safely gaining access to the sub-sternal space underneath the sternum/ribcage as well as tunneling subcutaneously above the ribcage for the purpose of positioning of a medical electrical lead. This eliminates the need for separate tools for tunneling in different extravascular spaces by providing a single tool capable of the multiple uses.

This disclosure describes various tools and associated methods suitable for gaining access to extravascular spaces. The various tools and associated methods utilize a boring tip that may rotate to aid in safely and effectively crossing diaphragmatic attachments. The boring tip may, in some instances not have any sharp edge. For example, the boring tip may have a dome shape but including at least one surface recessed and offset from a summit of the dome shape. Various mechanisms may be used to control rotation of the boring tip as described herein.

An apparatus and method for introducing portals into bone is described herein. An example apparatus for introducing portals into bone includes a handle, a base, and a driving member. The driving member can be made to project past the base by operating the handle. The base is detachable from the handle. The apparatus also includes a guide coupled at a first end to the handle and at a second end to the base. The base is detachably coupled to the guide. A base coupling detachably coupling the base to the guide includes an actuating member movable between a coupled configuration wherein the base is coupled to the guide and an uncoupled configuration wherein the base is released from the guide. The actuating member is arranged so that motion of the handle toward the base moves the actuating member from the coupled configuration to the uncoupled configuration.