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.

A surgical stapler can comprise an anvil comprising a staple pocket formed in a tissue contacting surface. The staple pocket can comprise a midline or centerline, a first forming cup, and a second forming cup. The first forming cup can comprise a first interior sidewall comprising a first vertical portion which is substantially perpendicular to the tissue contacting surface. The second forming cup can comprise a second interior sidewall comprising a second vertical portion which is substantially perpendicular to the tissue contacting surface. The first vertical portion and the second vertical portion can extend through the centerline, wherein the first interior sidewall and the second interior sidewall can comprise a trap for deforming a first staple leg of a staple to a first side of the centerline and for deforming a second staple leg of the staple to a second side of the centerline.

Described here are methods and systems for the manipulation of ovarian tissues. The methods and systems may be used in the treatment of polycystic ovary syndrome (PCOS). The systems and methods may be useful in the treatment of infertility associated with PCOS.

A coupling and related methods are disclosed herein that can provide for coupling a first object and a second object with minimal play. A coupling can include a first coupling component having a cylindrical surface with a screw and a pin extending therefrom and a second coupling component having a prismatic surface with a first and a second through-hole. The first coupling component and the second coupling component can be configured such that relative motion between the first coupling component and the second coupling component can be restricted in all six degrees of freedom when the screw is engaged with the first through-hole to secure the cylindrical surface of the first component against the prismatic surface of the second component. The pin can be configured to maintain stability of the coupling and further limit relative movement, such that positioning and/or orientation errors between the first and second components is minimized.

A surgical device includes an outer member, an inner member, and at least one locking element. The inner member is at least partially supported within the outer member. The at least one locking element is configured in a first arrangement of the surgical device to lock the inner member in a first position and configured in a second arrangement of the surgical device to unlock the inner member from the first position. The at least one locking element is configured to change from the first arrangement to the second arrangement upon coupling the inner member in an operational arrangement to a hand piece.

Devices and methods divert blood flow from a first vessel to a second vessel and maintain blood flow in the first vessel. The device includes a first segment and a second segment. The first segment is configured to anchor in the first vessel. The first segment includes a window to allow blood to flow into the first segment, through the window, and distal in the first vessel. The second segment is configured to anchor in the second vessel. The second segment is configured to allow blood to flow into the first segment, through the second segment, and into the second vessel.

A bone fastener includes a shaft. The shaft includes a wall that defines a longitudinal cavity and a plurality of openings in communication therewith. The openings are disposed in axial alignment along the shaft and the wall is closed exclusive of the openings. In some embodiments, systems, spinal constructs, surgical instruments and methods are disclosed.

A bearing structure includes a fixing member attached with respect to an arm of a surgical robot in a state in which a holder that is provided at a distal end of the arm is inserted inside the fixing member, a first drape that covers the arm being attachable to the fixing member, and a rotating member attached with respect to the fixing member in a slidably rotatable manner in a state in which the holder is inserted inside the rotating member, a second drape that covers the holder being attachable to the rotating member. The rotating member is rotatable together with the holder.

Described are a multipurpose handles that can be incorporated into medical device delivery systems. Also described are medical devices, including medical snare devices, that can incorporate the handles or features thereof. An actuation button of the multipurpose handle can be moved longitudinally to move a device portion (e.g. snare loop) longitudinally, e.g. for deployment or retraction. The actuation button can also be rotated to rotate a device portion (e.g. snare loop). Sealing arrangements can be provided and can provide sealing functions in respect of a controlled medical device structure while the actuation button is moved longitudinally or rotated. Methods of using the handles and medical snare or other devices incorporating them are also described.

An applicator instrument for dispensing surgical fasteners includes a housing, a firing system moveable along a first axis, a handle extending upwardly from the housing along a second axis that defines an acute angle with the first axis, the handle having an upper free end that defines a top of the applicator instrument, a trigger coupled with the housing for activating the firing system, and an elongated shaft extending from the distal end of the housing, the elongated shaft having a proximal shaft section extending along the first axis and a distal shaft section that is oriented at an angle relative to the proximal shaft section for extending upwardly toward the top of the applicator instrument. The trigger is squeezed for dispensing surgical fasteners from the distal end of the elongated shaft. The applicator instrument has at least one visual indicator for indicating a proper orientation for the applicator instrument in which the upper free end of the handle is positioned above the housing.