Apparatus for performing a minimally-invasive procedure, the apparatus comprising: a tool comprising: a shaft having a distal end and a proximal end; a handle attached to the proximal end of the shaft; and an end effector attached to the distal end of the shaft; wherein the shaft comprises a flexible portion extending distally from the proximal end of the shaft, and an articulating portion extending proximally from the distal end of the shaft, and wherein the articulating portion comprises a flexible spine; wherein a plurality of articulation cables extend through the shaft from the handle to the flexible spine, such that when tension is applied to at least one of the plurality of articulation cables, the flexible spine bends; wherein a rotatable element extends through the shaft from the handle to the end effector, such that when the rotatable element is rotated, the end effector rotates; and wherein an actuation element extends through the shaft from the handle to the end effector, such that when the actuation element is moved, the end effector is actuated.

A surgical cutting and fastening instrument comprises an end effector that has a shaft coupled thereto that is coupled to a robotic system. A tool mounting portion includes an electric, DC motor connected to a drive train in the shaft for powering the drive train. A power pack that comprises at least one charge-accumulating device connected to the DC motor for powering the DC motor is provided.

A steering tool includes an internal tube disposed inside an external tube. The internal and external tubes are arranged for longitudinal axial movement relative to one another. A distal end of the internal tube is fixedly joined to a distal end of the external tube. At least one of the internal and external tubes is slotted near the distal end thereof, and the longitudinal axial movement causes bending of the distal ends of the tubes.

A medical device system may include a sheath, a pusher wire, and a locking element. The sheath may have a first outer diameter adjacent to the proximal end and an enlarged outer diameter region having a second outer diameter greater than the first adjacent to the intermediate region. The pusher wire may be slidably disposed within a lumen of the sheath. The locking element may have a lumen extending therethrough. The locking element may have a first inner diameter adjacent to the distal end and a second inner diameter smaller than the first adjacent to the intermediate region. The locking element may configured to freely slide over a region of the sheath having the first diameter. When the locking element is disposed over the enlarged outer diameter region of the sheath having the second outer diameter, the locking element may be configured to depress the sheath radially inwards.

Devices, apparatus, and methods for catheter-based repair of cardiac valves, including transcatheter-mitral-valve-cerclage annuloplasty and transcatheter-mitral-valve reapposition. In particular, a target and capture device is provided for guiding a cerclage traversal catheter system through a cerclage trajectory, particularly through a reentry site of the cerclage trajectory. The target and capture device provides the user with a target through which the cerclage traversal catheter system must be guided, particularly under imaging guidance, so as to properly traverse the cerclage trajectory at any desired location, particularly at a reentry site. The target and capture device can, further, ensnare and externalize the cerclage traversal catheter system.

A lithotripsy device for tunneling through vascular occlusions comprises a tunneling catheter including a tunneling catheter shaft having a distal end and a proximal end. A tunneling probe is disposed on the distal end of the tunneling catheter shaft. The tunneling probe has a pair of electrodes; each electrode being operatively connected to an electrical lead within the tunneling catheter shaft. The leads are configured for operative connection to an external pulse generator. Activation of an external pulse generator operatively connected to the leads causes repeated electrical discharges between the electrodes. When the electrodes are an in a fluid, the repeated electrical discharges produce repeated hydraulic shock waves in the fluid directed away from the electrical discharges. When the repeated hydraulic shock waves strike calcified tissue, the calcified tissue is broken into a modified plaque. The modified plaque has a lower resistance to mechanical dislocation that the original calcified tissue.

Surgical devices and systems having rotating end effector assemblies for treating tissue are provided. Methods for using the same are also provided.

A guide wire of the present disclosure includes a core shaft having a distal end portion reducing in diameter, a coil body wound to cover the distal end portion, and a distal end fixing portion fixing the core shaft and the coil body to each other. The distal end portion includes a small diameter portion, a large diameter portion, and a tapered portion between the small diameter portion and the large diameter portion. The core shaft and the coil body are fixed at a portion excluding the tapered portion. A first bending rigidity FR1 of the large diameter portion, a second bending rigidity FR2 of the small diameter portion, and a length L of the tapered portion satisfy the following expressions (1) and (2). In the following expressions (1) and (2), the unit of L is mm (millimeter).

FR1/FR210(1)

1L3(2)

A surgical system comprising an RF energy source, a first cartridge including a first electrode, a second cartridge including fasteners and fastener drivers, and a surgical instrument is disclosed. The surgical instrument comprises a shaft, a drive member, and an end effector articulable relative to the shaft. The end effector comprises an anvil and an elongate channel selectively and interchangeably attachable to either one of the first cartridge and the second cartridge. The anvil comprises a second electrode configured to cooperate with the first electrode to deliver RF energy, and anvil pockets configured to cooperate with the fastener drivers to form the fasteners. The first cartridge completes an RF energy circuit connecting the RF energy source to the first electrode when attached to the elongate channel. The fastener drivers are configured to be driven by the drive member when the second cartridge is attached to the elongate channel.

A staple cartridge comprises an outer tissue-contacting surface comprising at least one first staple cavity. The at least one first staple cavity is configured to receive at least one first staple that includes a first staple leg with a first tip protruding beyond the outer tissue-contacting surface when the at least one first staple is in an unfired position. The staple cartridge includes an inner tissue-contacting surface comprising at least one second staple cavity. At least one pocket extender protrudes from the outer tissue-contacting surface, wherein the at least one pocket extender is configured to conceal the first tip when the at least one first staple is in the unfired position. The inner tissue-contacting surface cooperates with the outer tissue-contacting surface and the at least one pocket extender to define a contoured frame configured to reduce friction against tissue as the staple cartridge is moved relative to tissue.