A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

A deployable and flexible tooltip camera is provided for integration within a shaft of an endoscopic tool. The tooltip camera includes a camera mounted to a distal tip of a curved tube which is capable of rotational and translational movement to provide a wide field of view of a tooltip of the endoscopic tool during an endoscopic procedure. The tube retains its curved shape when in use to provide a unique perspective view of the tooltip, but can then be withdrawn into a shaft of the endoscopic tool such that the entire tooltip camera and tube are retained within the shaft of the endoscopic tool and can pass through a cannula. The curved tube may be formed of a super-elastic memory alloy like Nitinol and pre-shaped into an s-curve using a two-step heat treatment process to attain the necessary curvature, and further laser-patterned with holes to attain the necessary flexibility.

Clip for an aneurism suitable for being implanted into tissue in which an aneurism has formed and carrying out a tight closure of the aneurism which comprises a pair of claw members (2a, 2b) made of non-metallic material, said claw members being provided with articulated joining means (3) which allow the rotation of the pair of claw members around a pivot (4) which interlocks them, the clip being able to adopt at least one opening position (A) and one closure position (B); the clip being provided with at least one spring element (6) at least partially housed in the clip which bends to arrange the clip in closure position which comprises at least one flexible (7) and elastic element with a section with arced configuration (8), press-fitted with two opposing ends (9a, 9b) each one exerting pressure on a different claw member both in the opening and in the closure position.

An applicator instrument for dispensing surgical fasteners includes a housing, and an elongated shaft extending from the housing. The elongated shaft has a proximal end secured to the housing, a distal end spaced from the proximal end, and a first axis extending between the proximal and distal ends of the elongated shaft. Surgical fasteners are disposed in the elongated shaft. The surgical fasteners are stacked at an angle relative to the first axis of the elongated shaft. A distal end cap having a surgical fastener dispensing window is secured to the distal end of the elongated shaft. The applicator instrument has a firing system disposed in the housing, and an actuator coupled with the firing system for activating the firing system to dispense the surgical fasteners through the surgical fastener dispensing window.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, the catheter can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to a leaflet suture. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

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 method of removing tissue in a body lumen includes advancing a tissue-removing catheter over a guidewire in the body lumen to position a distal end of the catheter adjacent the tissue and a proximal end portion of the catheter outside of the body lumen. The catheter includes an elongate body, a tissue removing element mounted on a distal end portion of the elongate body, and an inner liner disposed within the elongate body. The inner liner defines a guidewire lumen in which the guidewire is disposed during the advancement of the catheter. The method further includes rotating the elongate body and tissue-removing element of the catheter to remove the tissue. Detecting wear of the inner liner caused by the elongate body contacting the inner liner during use.

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.