Disclosed herein are devices (e.g., needles (e.g., hollow needles), hollow staples, articles, apparatuses, and systems), kits, and methods for treating skin and skin conditions, for example, by promoting skin tightening, such as by reducing skin laxity and reducing tissue area or volume.

A surgical instrument includes a shaft assembly, a stapling assembly disposed at a distal end of the shaft assembly and extending along a central axis, and an anvil configured to selectively couple with the stapling assembly to compress a tissue and form staples in the tissue. The stapling assembly includes a housing assembly that includes a proximal housing and a distal housing. The proximal housing is secured to the shaft assembly and is separable from the distal housing to thereby releasably couple the distal housing with the shaft assembly. The stapling assembly further includes a deck member having an annular array of staple openings configured to receive a plurality of staples, and a knife member at least partially disposed within the housing assembly.

Methods and tools for implanting prosthetic heart valves and modifying leaflets of an existing valvular structure in a subject are disclosed herein. Prior to or during implantation of the prosthetic heart valve within the existing valvular structure, each tool can be provided in the ascending aorta (or equivalent thereof) of a subject and can be used to pierce, lacerate, slice, tear, cut or otherwise modify a leaflet or commissure of the existing valvular structure. The existing valvular structure can be a native aortic valve or other native heart valve, or a previously-implanted prosthetic heart valve. The modification can avoid, or at least reduce the likelihood of, issues that leaflets of the existing valvular structure might otherwise cause once the prosthetic heart valve has been fully installed, for example, obstruction of blood flow to the coronary arteries and/or improper valve mounting due to a non-circular cross-section.

Disclosed herein is a medical device. The medical device includes an outer tubular member and an inner tubular member. The outer tubular member has a distal end, an open window disposed at the distal end, and one or more dimples. The inner tubular member has a distal tip and one or more axial grooves. The inner tubular member is configured to be received within the outer tubular member. The one or more axial grooves and the one or more dimples are configured to align the distal tip of the inner tubular member with the open window of the outer tubular member. The open window of the outer tubular member and the distal tip of the inner tubular member are configured to cut tissue.

An endoluminal traversing system and tissue crossing system are described wherein the access systems are controlled by actuators that allow for robotic control of system functions. The robotic system can be configured for full manual control over the actuators, full computerized control, or a combination of human and computer (AI, neural net, rule set) guidance.

An endoluminal punch and introducer sheath are described wherein the endoluminal punch comprises a guidewire lumen through which a user is capable of placing a guidewire. The endoluminal punch system further comprises a mechanism affixed to the hub which is capable of controlling the axial positioning of the guidewire relative to the endoluminal punch distal end. The control mechanism can be released so that the endoluminal punch can be removed from a patient while retaining the guidewire in place within the patient. The endoluminal punch introducer, including a sheath and dilator, can comprise energy emitting electrodes or transducers for cutting larger size holes in stubborn (friable, scarred, or fibrotic) tissue. In other embodiments, the endoluminal punch can comprise a guidewire or stylet, wherein the guidewire or stylet is capable of emitting energy to cut through tissue.

A surgical instrument navigation system and method of use is provided that visually simulates a virtual volumetric scene of a body cavity of a patient from a point of view of a surgical instrument residing in the cavity of the patient, wherein the surgical instrument, as provided, may be a steerable surgical catheter with a biopsy device and/or a surgical catheter with a side-exiting medical instrument, among others. Additionally, systems, methods and devices are provided for forming a respiratory-gated point cloud of a patient's respiratory system and for placing a localization element in an organ of a patient.

An apparatus for harvesting a vessel from a body, includes: a cannula having a dissector for advancing along the vessel to create a tunnel, the dissector having a transparent portion; and an energy tool moveably coupled to the cannula, wherein the energy tool is configured to separate a pediculated vessel having at least a segment of the vessel and a pedicle around the segment of the vessel from surrounding tissue, and wherein at least a part of the energy tool is visible through the transparent portion of the dissector during use of the energy tool.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Disclosed herein are apparatuses, systems, kits, and methods for treating skin, such as skin tightening or for treating diseases, disorders, and conditions that would benefit from tissue area or volume reduction, skin restoration, skin tightening, skin lifting, and/or skin repositioning and/or for generally improving skin function or appearance (e.g., the removal of unwanted skin features or irregularities such as sebaceous glands, sweat glands, hair follicles, necrosis, and fibrosis). Such apparatuses, systems, kits, and methods comprise an apparatus having a handheld main body and a detachably attachable tip comprising one or more needles.