An endoscopic vessel harvesting system for surgical removal of a blood vessel to be used for coronary bypass uses endoscopic instruments for isolating and severing the vessel. An endoscopic camera in the endoscopic instruments captures images from a distal tip of the instrument within a dissected tunnel around the vessel. An image processor assembles a three-dimensional model of the tunnel from a series of images captured by the endoscopic camera. An augmented-reality display coupled to the image processor renders (e.g., visibly displays to the user in their field of view) a consolidated map representing the three-dimensional model along with a marker in association with the map indicating a current location of the distal tip.

A vessel harvesting system removes a target vessel from a patient for use as a bypass. An elongated harvesting instrument inserts into a body along a path of a target vessel which includes at least one side branch. The harvesting instrument includes a cutter for applying thermal energy to sever and cauterize the side branch. An endoscopic camera captures visible-light images from a distal tip of the instrument within a dissected tunnel around the target vessel. A thermal camera captures thermograms coinciding with the visible-light images to characterize a temperature present at respective surfaces in the tunnel. An image processor (e.g., an electronic controller) renders a video stream including the visible-light images and an overlay depicting the temperatures present on at least some of the respective surfaces when applying the thermal energy. A display presenting the video stream and overlay to a user can be an augmented-reality display.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy.

The present invention relates to a device and method for making sclerosing foam, which is useful in the treatment of varicose veins and other venous conditions. The device comprises a continuous pathway that is at least partly formed of flexible or compressible material and that comprises a foam generating structure within the continuous pathway; the foam generating structure being formed of two or more elements, wherein each element defines at least one passageway of cross sectional area 1 μm2 to 10 mm2 and said two or more elements being arranged in series; a port which allows introduction of material into or extraction of material out of the continuous pathway; and a liquid pathway that is at least partly formed of flexible or compressible material and is arranged to deliver liquid into the foam generating structure between a first and second element of the foam generating structure.

A system for harvesting a tendon graft is disclosed, including a retractor, a guide and a harvesting tool. The retractor is collapsible and upon release, becomes self-supporting to hold open an anatomic space developed in a patient above the tendon. A guide assembles with the retractor to orient a guide shaft along the retractor and thereby the anatomic space. The harvesting tool includes a working end with a blade edge for cutting into the tendon. The harvesting tool defines a contoured surface for engaging and translating along the guide shaft while assembled to the retractor. The guide shaft and contoured surface limit the trajectory and translation extent of the harvesting tool along and into the tendon.

A surgical device includes a handle assembly, an elongated portion, an end effector, a visualization device, and a constant horizon mechanism. The elongated portion extends distally from the handle assembly and defines a longitudinal axis. The end effector is rotatable about the longitudinal axis relative to the handle assembly. The visualization device defines a visualization axis. A first portion of the visualization device extends through the elongated portion, and a second portion of the visualization device is disposed at least partially within the handle assembly. The visualization device is rotatable about the longitudinal axis relative to the handle assembly. The constant horizon mechanism is disposed in operative engagement with the visualization device and is configured to prevent the visualization device from rotating about the visualization axis when the visualization device rotates about the longitudinal axis.

A hydrodissector for hydrodissecting a vascular target, the hydrodissector comprising: a handle; a shaft extending from the handle at an angle and including a tip at a distal end thereof; at least one port provided at the tip and configured to be coupled to a fluid supply and to eject fluid from the at least one port into the space between the vascular target and surrounding tissues to dissect the vascular target from the surrounding tissues, the at least one port being sized to provide sufficient pressure and velocity to dissect the vascular target from the surrounding tissues, wherein the length of the shaft is configured for insertion into an incision to atraumatically hydrodissect the vascular target from the surrounding tissues, and wherein the shaft is configured to releasably couple with one or more hook-shaped attachments configured to lift the vascular target after the vascular target is dissected from the surrounding tissues.

A system for preparing a harvested blood vessel for use as a graft during a coronary artery bypass procedure, which includes an elongated platform, a mounting flange extending upwardly from a top surface of the platform adjacent a proximal end thereof for supporting a syringe in a fixed position, and a pair of longitudinally spaced apart clamp holders operatively associated with the top surface of the platform, each clamp holder configured to support a respective vessel clamp, wherein the vessel clamps supported within the clamp holders are adapted to hold a harvested blood vessel immobile therebetween so it can be prepared for grafting.

A harvesting assembly for harvesting a tissue graft from surrounding tissue is disclosed including a guide. The guide includes a means for fixedly engaging with an anterior surface of the tendon. The guide also includes a means of guiding a cutting blade along a preferred trajectory into and along a length of the tendon. The guide also includes a means of guiding a truncating blade along a preferred trajectory across a width of tendon. The cutting blade may include two parallel blades for forming lateral sides of the tendon graft simultaneously. Each of the two parallel blades may define a leading edge that extends along at least a 90 degree arc that is equidistant from a stop on the cutting blade. The stop in combination with the guide may limit a cut depth into the tendon for a range of cutting blade handle elevation angles.