A steerable laser probe may include a handle having a handle distal end and a handle proximal end, an actuation control of the handle, a housing tube having a housing tube distal end and a housing tube proximal end, a first housing tube portion having a first stiffness, a second housing tube portion having a second stiffness, an optic fiber disposed within an inner portion of the handle and the housing tube, and a cable disposed within the housing tube and the actuation control. A rotation of the actuation control may be configured to gradually curve the housing tube and the optic fiber. A rotation of the actuation control may be configured to gradually straighten the housing tube and the optic fiber.

The endoscope herein described has a unique steering capability allowing the highly flexible distal end of the shaft of the device to be moved to a full range angular positions without rotating the device on its long axis, thus enabling the device to be steered within the cavity of interest. The relative lengths of the control cables used to move the distal end of the bendable shaft can be changed whenever the flexible or malleable shaft is to be re-shaped to a new configuration thus preventing the distal end or the steering mechanism from assuming an undesired angular position. When used as an endotracheal device, a novel tongue retractor is described which forms an internal conduit, allowing passage of the bendable shaft of the endotracheal intubation device and an endotracheal tube therethrough. Methods for performing a tracheal intubation and changing the relative lengths of the cables are disclosed.

A steerable medical device includes a handle having a handle body and a first control assembly that is movable with respect to the handle body. A first cam is housed within the handle body and is coupled to the control assembly. Movement of the control assembly with respect to the handle body drives rotation of the cam with respect to the handle body. A first slider is housed within the handle body and is coupled to the cam. Rotation of the cam drives translation of the slider within the handle body. An elongate tool extends from the handle. A first control wire is coupled between the first slider and the tool. Translation of the first slider causes tensioning of the control wire, and tensioning of the control wire causes deflection of the tool.

A surgical apparatus comprises a body, an ultrasonic transducer, a shaft, an acoustic waveguide, an articulation section, an end effector, and an articulation drive assembly. The ultrasonic transducer is operable to convert electrical power into ultrasonic vibrations. The shaft couples the end effector and the body together. The acoustic waveguide is coupled with the transducer. The articulation section includes a collar that is located distal to a nodal portion of the waveguide and is operable to deflect the end effector away from the longitudinal axis. The end effector comprises an ultrasonic blade in acoustic communication with the ultrasonic transducer. The articulation drive assembly is operable to drive articulation of the articulation section. The articulation drive assembly comprises at least one translating articulation driver coupled with the collar. The ultrasonic blade is operable to deliver ultrasonic vibrations to tissue even when the articulation section is in an articulated state.

Devices, systems, and methods are provided for image-guided interventional procedures and other uses. Nested articulated catheter shaft systems may have an imaging catheter with an ultrasound transducer supported by a fluid-driven articulated sheath portion. Drive fluid can be transmitted distally along an asymmetric sheath via eccentric passages to an articulated portion of the imaging catheter distal of a port. An articulated shaft supporting a therapeutic tool can be advanced within a working lumen of the imaging sheath to the port so that the tool is within a field of view of the transducer. The fluid transmission channels may take much less cross-sectional area of the sheath than a mechanical pull-wire system, allowing the nested sheath/shaft system to provide safer access to a chamber of the heart and to facilitate precise independent control over 3D ultrasound imaging and image-guided structural heart therapies or the like.

A steerable instrument for endoscopic and/or invasive type of applications, such as in surgery, which has an elongated tubular body having a proximal end part with a first actuation flexible zone having a first diameter and a distal end part having a first distal flexible zone having a second diameter that is different from the first diameter. A cylindrical diameter adaptation section is arranged to connect the proximal end part to the distal end part such that a flexion in a radial direction relative to a longitudinal center axis of the longitudinal tubular body of the first actuation flexible zone results in an amplified or attenuated flexion of the first distal flexible zone.

A system including a self-expanding prosthesis configured to foreshorten during deployment thereof and a delivery device configured to percutaneously deliver the self-expanding prosthesis. The delivery device includes a handle having an actuator thereon, an outer sheath including a proximal end coupled to the handle and a pusher shaft slidingly disposed within the outer sheath. The pusher shaft has a proximal end coupled to the handle and a distal end configured to releasably couple to the self-expanding prosthesis such that the self-expanding prosthesis axially moves therewith. The inner shaft has a distal portion of the inner shaft that is configured to receive a self-expanding prosthesis thereon. The outer sheath and the pusher shaft are configured to simultaneously move in opposing axial directions via actuation of the actuator on the handle to compensate for the foreshortening of the self-expanding prosthesis during deployment.

A handle for a medical device includes a handle body and a knob that is rotatable with respect to the handle body. A first gear is associated with the knob. A slide assembly is housed within the handle body or the knob. The slide assembly includes a first lead screw. A second gear is associated with the slide assembly. A third gear is housed within the handle body or the knob and is coupled between the first gear and the second gear. Rotation of the knob drives rotation of the first gear, rotation of the first gear drives rotation of the third gear, rotation of the third gear drives rotation of the second gear, and rotation of the second gear drives rotation of the lead screw.

An ultrasonic surgical instrument and method of deflecting an end effector include an acoustic waveguide with a proximal waveguide body portion defining a longitudinal axis, a distal waveguide body portion having an ultrasonic blade distally projecting therefrom, and an articulation body portion extending between the proximal and distal waveguide body portions. The articulation body portion of the acoustic waveguide is configured to flex a first direction to thereby deflect the ultrasonic blade relative to the longitudinal axis and through a first plane. In addition, the articulation body portion of the acoustic waveguide is further configured to flex a second direction to thereby deflect the ultrasonic blade relative to the longitudinal axis and through a second plane. The second direction is different than the first direction such that the second plane is different than the first plane for multiplanar deflection of the ultrasonic blade relative to the longitudinal axis.

An endoscope comprising: a tubular elongated member; a tensioning wire in a tensioning lumen along one side of the elongated member, between the proximal end and the distal end of the elongated member; a head arranged at the distal end of the elongated member and comprising: a tubular tensioning ring attached to the distal end of the tensioning wire and having a same external diameter as the elongated member; an imaging sensor having a rectangular cross section, arranged at a distal end of the head; and a tubular distal shell arranged longitudinally around the imaging sensor and having an inner diameter identical to or slightly larger than a diagonal of the rectangular cross section of the imaging sensor; wherein a tubular jacket sheathes the elongated member and the tensioning ring of the head.