Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

An insertable robot for minimally invasive surgery includes a tube array having a guide tube housed within a straightening tube. The guide tube includes a curved working end. The guide tube may be axially translated and rotated relative to the straightening tube such that the curved working end is constrained inside the straightening tube, causing the curved working end to achieve a smaller dimension. The tube array is inserted into a working channel on an endoscope, resectoscope or trocar. Once the tube array is inserted, the curved working end of the guide tube is translated forward beyond the distal end of the working channel, allowing the curved working end to return to its pre-formed shape. A surgical tool is inserted through the guide tube for an operation. The straightening tube allows the guide tube curved working end to be temporarily straightened during insertion and removal of the tube array.

Disclosed are a system and method to implement a novel treatment to restore bilateral longitudinal parallel paraurethral support, the system comprising a trocar, and introducer, and one or more barbed suture-type devices, the components used cooperatively to implant the one or more barbed suture-type devices in the patient to provide sufficient paraurethral support to restore continence in the patient.

Systems and methods can be employed for trans-tympanic membrane access to the middle ear for delivery of a therapeutic agent, for example, to the round window niche adjacent to the cochlea under direct visualization. The systems and methods can also be used to improve accessibility and visualization for various otological surgical procedures, such as, but not limited to, cholesteatoma removal, tympanic membrane repair and ossicular chain repair.

Systems and methods for planning delivery of an object via a catheter, such as transseptal delivery of a prosthetic mitral valve to a patient's heart are disclosed.

A control handle for a steerable catheter body for navigation of the catheter body through a biological lumen and manipulation at a treatment site. The control handle includes a housing assembly that houses a piston assembly and a resistance adjusting assembly. The resistance adjusting assembly can be adjusted to provide the desired frictional characteristics of the user for control of the resistance between the piston assembly and the housing assembly. In one embodiment, the piston assembly is configured to provide a frictional resistance that varies dynamically to substantially match the restorative force across the range of catheter tip deflection. Other embodiments include a vibrating member that provides tactile feedback to the operator to indicate conditions at the distal end of the catheter, such as contact force.

A system and method for guidance of a device having a curved needle to a target tissue includes a tracking system having an imaging component, a processor, and a curved needle with known geometric parameters. The processor is configured to calculate a needle trajectory based on geometric considerations of the needle and the target tissue. Additional features and methods of the invention include a display with an annotated overlay for directing and tracking the curved device.

An implantable device for optically stimulating a brain of a human being or animal, including: a multi-channel biocompatible catheter including a plurality of channels extending substantially parallel to each other relative to a longitudinal axis of the multi-channel catheter; a light guide, extending into one channel, for optically stimulating the brain, the multi-channel catheter acting as a sheath totally enveloping the light guide; a functional element, extending into another channel, to measure light injected into a surrounding medium at a distal end of the light guide and/or an element acting on the shape of the multi-channel catheter.

An example aspiration system includes an inner member configured to be received within an aspiration catheter lumen and disrupt a thrombus positioned within vasculature of a patient. The inner member includes a distal member at a distal portion of an elongated support member, where the distal member is configured to fit within the aspiration catheter lumen. The distal member defines a larger cross-sectional dimension than the elongated support member, the cross-section being taken in a direction orthogonal to a longitudinal axis of the support member, and is configured to be deployed distally outward from a distal opening of the aspiration catheter lumen to contact and disrupt a thrombus to facilitate the efficiency of a medical aspiration procedure. The distal member may include one or more tapered portions and a surface disruption configured to aid with the thrombus disruption.

A septostomy device 10 with a cutting structure or means 140 and tissue capture mechanisms 240, 250 is disclosed, along with a medical procedure for using the device. The system 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.