2952 results about "Target site" patented technology

An electrosurgical cutting blade (1) comprises a first electrode (2), a second electrode (3), and an electrical insulator (4) separating the first and second electrodes. The first and second electrodes have dissimilar characteristics (cross-sectional area, thermal conductivity etc.) such that the first electrode (2) is encouraged to become an active electrode and the second electrode (3) is encouraged to become a return electrode. The spacing between the first and second electrodes (between 0.25 mm and 3.0 mm) and the peak voltage supplied to the electrodes (2 and 3) are both selected such that arcing does not occur directly between the electrodes, but between the first electrode and the tissue at the target site. The arrangement is such that, in use, a thermal differential of at least 50° C. is established between the first and second electrodes (2 and 3), such that the second electrode is maintained below a temperature of 70° C. This is achieved either by thermally insulating the second electrode from the first electrode, and / or by transferring heat away from the second electrode, e.g. by conduction, forced cooling, or by means of a heat pipe (27).

Devices for affixing sutures, grafts and tissues to bone, and soft tissue such as periosteum. Such devices are designed to be deployed and selectively positioned at a target site and remain seated thereat. The devices are further provided with attachment structures for securing sutures, grafts, synthetic materials or tissues thereto which facilitates the ability of such devices to remain more firmly in position.

A method of administering a drug whereby a fine drug powder can be accurately administered to a target site (in particular, a target site in the body cavity) via fluidization and spraying with a gas by using a micro tube. Concerning the administration mode, in particular, the drug alone or a biopolymer is administered or the biopolymer is employed as a carrier in the above method. More specifically speaking, a method of administering a fine drug powder which comprises finely milling one or more types fine particles of the drug and / or the biopolymer, blending them each other, fluidizing the blend with a gas, then transporting the fluidized matter in a micro tube by the gas stream and spraying the fine drug powder from the tip of the micro tube toward the target site. Further, an administration method which comprises concentrically providing a capillary tube in the micro tube, supplying an aqueous solution of the drug and / or the biopolymer from the capillary tube into the gas stream and then mixing it with other fine particles of the drug and / or the biopolymer under transportation by the gas.

A method of securing a prosthesis placed at a desired site in a passageway of a human body comprises delivering a fastener having a proximal piercing end portion and a distal piercing end portion to a site where a prosthesis having a tubular wall has been placed in the passageway, which has a wall, advancing the proximal piercing end portion beyond the prosthesis, penetrating the proximal piercing end portion into the wall of the passageway without passing the proximal piercing end portion through the tubular wall of the prosthesis, and passing the distal piercing end portion through the tubular wall of the prosthesis and into the wall of the passageway. One surgical fastener delivery apparatus for delivering a surgical fastener to a target site comprises a support having a first end, a second end, and a longitudinal axis and being adapted for placement in a passageway in a human body. A surgical fastener having a first piercing end portion, a second piercing end portion and a central portion extending therebetween and having a longitudinal axis is releasably mounted to the support with the central portion longitudinal axis generally parallel to the support longitudinal axis.

The invention provides methods and systems for introducing a delivery device in the heart at or near the apex of the heart, wherein the delivery device includes a prosthesis, advancing the prosthesis to the target site, and disengaging the prosthesis from the delivery device at the target site for implantation. Specifically, the present invention provides valve replacement systems for delivering a replacement heart valve to a target site in or near a heart. The valve replacement system comprises a trocar or other suitable device to penetrate the heart at or near the apex of the heart, a delivery member that is movably disposed within the trocar, and a replacement cardiac valve disposed on the delivery member. The delivery member may further comprise mechanical or inflatable expanding members to facilitate implantation of the prosthetic valve at the target site.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and / or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

A remote control flexible instrument system, employing a shaft which supports a tool, is described in which the has proximal and distal ends with at least a portion thereof extending through a lumen of the human body so as to locate the shaft at an internal target site. A master station including an input device provides control of the instrument situated at a slave station. The master station can control at least one degree-of-freedom of the flexible instrument. A controller intercouples the master and slave stations and is operated in accordance with a computer algorithm that receives a command from the input device for controlling at least one degree-of-freedom of the catheter so as to respond in accordance with action at the input device. The flexible instrument further comprises a controlled flexible segment along the shaft, for controlled bending at the flexible segment to guide the shaft and to dispose the tool at an operative site.

The present invention provides systems and methods for the repair, removal, and / or replacement of heart valves. The methods comprise introducing a delivery system into the heart, wherein a prosthesis is disposed on the delivery member attached to the delivery system, advancing the prosthesis to the target site, and disengaging the prosthesis from the delivery member at the target site for implantation. The present invention also provides implant systems for delivering a prosthesis to a target site in or near the heart. In one embodiment of the present invention, the implant system comprises a delivery system, an access system, and a prosthesis.

Bone anchors, methods for deploying anchors, and systems for attaching ligaments and tendons to bone are disclosed. The bone anchors of the present invention are operative to remain firmly positioned within a target site of bone and provide means for selectively adjusting the degree of tension to one or more sutures secured thereto. The bone anchors are further operative to be utilized to connect tendons and ligaments directly to bone, as well as may be selectively utilized to adjustably position an implant or other anatomical structure held thereby. There is further disclosed methods for deploying a bone anchor utilizing a blind procedure that is expeditious, accurate and substantially less traumatic than prior art bone deployment techniques.

Molecular cross-linked gels comprise a variety of biologic and non-biologic polymers, such as proteins, polysaccharides, and synthetic polymers. Such molecular gels may be applied to target sites in a patient's body by extruding the gel through an orifice at the target site. Alternatively, the gels may be mechanically disrupted and used in implantable articles, such as breast implants. When used in vivo, the compositions are useful for inhibiting post-surgical spinal and other tissue adhesions, for filling tissue divots, tissue tracts, body cavities, surgical defects, and the like.

A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and / or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site. Some embodiments of the surgical access system may be particularly suited for establishing an operative corridor to a surgical target site in the spine. Such an operative corridor may be established through the retroperitoneal space and the psoas muscle during a direct lateral, retroperitoneal approach to the spine.

A multi-layer occluder for treating a target site within the body is provided. The occluder may include first and second layers. For example, the first layer may include braided strands of metallic material, and the second layer may include braided strands of polymeric material. At least one of the first or second layers may be configured to facilitate thrombosis.

A variety of steerable needles, lancets, trocars, stylets, cannulas and systems are provided for examining, diagnosing, treating, or removing tissue from a patient. The steerable needles, trocars, stylets, cannulas and systems also provide a platform for delivery of target materials, such as therapeutics, biologics, polymers, glues, etc., to a target site. An embodiment of the invention includes a steerable device for use in accessing target site in a patient comprising: a steerable member adapted to penetrate tissue; and a steering mechanism adapted to be operated by a user to apply a bending force to bend the steerable member to access the target site.

The present invention relates to a method of affecting a hypothalamic-related condition by electrically and / or chemically stimulating the hypothalamus. Also provided are methods of stimulating a hypothalamic-related target site by responding to a sensor signal relating to a physiological activity of the body associated with the hypothalamic-related condition desired to be affected. The present invention also describes a method of directly or indirectly modulating hormones synthesized or released by the hypothalamus to affect hypothalamic-related conditions involving hormonal function, dysfunction or imbalance.

A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and / or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site, such as a synovial joint, of a patient. An electrosurgical probe of the invention includes a shaft, and a working end having an electrode array comprising an outer circular arrangement of active electrode terminals and an inner circular arrangement of active electrode terminals. The electrode array is adapted for the controlled ablation of hard tissue, such as meniscus tissue. The working end of the probe is curved to facilitate access to both medial meniscus and lateral meniscus from a portal of 1 cm. or less.

Prosthesis delivery devices and methods are provided that enable precise control of prosthesis position during deployment. The prosthesis delivery devices may carry multiple prostheses and include deployment mechanisms for delivery of a selectable number of prostheses. Control mechanisms are provided in the prosthesis delivery devices that control either or both of the axial and rotational positions of the prostheses during deployment. This enables the deployment of multiple prostheses at a target site with precision and predictability, eliminating excessive spacing or overlap between prostheses. In particular embodiments, the prostheses of the invention are deployed in stenotic lesions in coronary or peripheral arteries or in other vascular locations.

A system for extracting a bodily fluid sample (e.g., an interstitial fluid [ISF] sample) and monitoring an analyte therein includes a disposable cartridge and a local controller module. The disposable cartridge includes a sampling module adapted to extract a bodily fluid sample and an analysis module adapted to measure an analyte (e.g., glucose) in the bodily fluid sample. The local controller module is in electronic communication with the disposable cartridge and is adapted to receive and store measurement data from the analysis module. An ISF extraction device includes a penetration member configured for penetrating and residing in a target site of a user's skin layer and, subsequently, extracting an ISF sample therefrom. The device also includes a pressure ring(s) adapted for applying pressure to the user's skin layer in the vicinity of the target site. The device is configured such that the pressure ring(s) is capable of applying pressure in an oscillating manner whereby an ISF glucose lag of the ISF sample extracted by the penetration member is mitigated. A method for extracting ISF includes providing an ISF fluid extraction device with a penetration member and a pressure ring(s). Next, a user's skin layer is contacted by the pressure ring(s) and penetrated by the penetration member. An ISF sample is then extracted from the user's skin layer while pressure is being applied in an oscillating manner by the pressure ring(s). The oscillating pressure mitigates an ISF glucose lag of the extracted ISF sample extracted.

A catheter or lead having a flexible printed circuit for conveying signals and / or energy. Each trace may be in electrical connection with one or more external electrical contacts. More specifically, each trace is typically electrically connected to a single contact. The traces and contacts may assist in diagnosis and / or detection of bio-electrical signals emitted by organs, and may transmit such signals to a connector or diagnostic device affixed to the catheter. The external electrical contacts may detect bioelectric energy or may deliver electrical or thermal energy to a target site.

A fixation device fixes the position of an implantable microminiature device residing proximally to a target site such as a nerve or a muscle. In one embodiment, the device comprises a sheath and a means for attaching the device to adjacent tissue. The means for attaching may be any one of several embodiments including one or more grasping members, a combination of grasping members and one or more helices, or an extension adapted to accept a suture. In another embodiment, the fixation device comprises an assembly residing in the implantation pathway, behind the stimulation device, thus preventing retreat of the stimulation device in the pathway. In a preferred use, the fixation device fixes the position of a microstimulator component of a Peripheral Nerve Stimulation (PNS) system.

The present invention involves systems and related methods for performing surgical procedures and assessments, including the use of neurophysiology-based monitoring to: (a) determine nerve proximity and nerve direction to surgical instruments employed in accessing a surgical target site; (b) assess the pathology (health or status) of a nerve or nerve root before, during, or after a surgical procedure; and / or (c) assess pedicle integrity before, during or after pedicle screw placement, all in an automated, easy to use, and easy to interpret fashion so as to provide a surgeon-driven system.

An interstitial fluid (ISF) extraction device includes a penetration member configured for penetrating a target site of a user's skin layer and, subsequently, residing in the user's skin layer and extracting an ISF sample therefrom and at least three concentrically-arranged pressure rings, each adapted for applying pressure to the user's skin layer in the vicinity of the target site while the penetration member is residing in the user's skin layer. In addition, the ISF extraction device is configured such that (i) the pressure rings apply pressure in an oscillating manner with asymmetric deployment and retraction cycles and (ii) only one of the at least three concentrically-arranged pressure rings is deployed at a time, thereby mitigating an ISF glucose lag of the ISF sample extracted by the penetration member.

Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site of a patient. An electrosurgical apparatus of the invention includes an active electrode assembly having an active electrode screen surrounded by a plurality of flow protectors. Each flow protector defines a shielded region of the active electrode screen, each shielded region of the screen characterized by enhanced plasma formation. The active electrode assembly is adapted for removing tissue from a surgical site, and the active electrode screen is adapted for digesting fragments of resected tissue. In one embodiment, the apparatus is particularly suited to simultaneously removing both hard and soft tissue in, or around, a joint.

This invention is directed to prodrugs that can be activated at the preferred site of action in order to selectively deliver the corresponding therapeutic parent drugs to target cells or to the target site. This invention will therefore primarily but not exclusively relate to tumor cells as target cells. More specifically the prodrugs are compounds of the formula V—(W)k—(X)l—A—Z, wherein: V is a specifier; (W)k—(X)l—A is an elongated self-elimination spacer system; W and X are each a 1,(4+2n) electronic cascade spacer, being the same or different; A is either a spacer group of formula (Y)m wherein: Y is a 1,(4+2n) electronic cascade spacer, or a group of formula U being a cyclization elimination spacer; Z is a therapeutic drug; k, l and m are integers from 0 (included) to 5 (included); n is an integer of 0 (included) to 10 (included), with the provisos that: —when A is (Y)m: k+l+m≧1, and if k+l+m=1; —when A is U: k+l≧1.

Methods and apparatus for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. In a method of the invention high frequency (RF) electrical energy is applied to one or more active electrodes on an electrosurgical probe in the presence of an electrically conductive fluid to remove, contract or otherwise modify the structure of tissue targeted for treatment. In one aspect, a dura mater and spinal cord are insulated from the electrical energy by an insulator positioned on a non-active side of the probe. In another aspect, a plasma is aggressively formed in the electrically conductive fluid by delivering a conductive fluid to a distal end portion of the probe and aspirating the fluid from a location proximal of the return electrode. In another aspect, a distal end of an electrosurgical probe having at least one electrode on a biased, curved, bent, or steerable shaft is guided or steered to a target site within an intervertebral disc having a disc defect for treatment of tissue to be treated at the target site by the selective application of electrical energy thereto.

Systems and methods are provided for applying a high frequency voltage in the presence of an electrically conductive fluid to create a relatively low-temperature plasma for ablation of tissue adjacent to, or in contact with, the plasma. In one embodiment, an electrosurgical probe or catheter is positioned adjacent the target site so that one or more active electrode(s) are brought into contact with, or close proximity to, a target tissue in the presence of electrically conductive fluid. High frequency voltage is then applied between the electrode terminal(s) and one or more return electrode(s) to generate a plasma adjacent to the active electrode(s), and to volumetrically remove or ablate at least a portion of the target tissue. The high frequency voltage generates electric fields around the active electrode(s) with sufficient energy to ionize the conductive fluid adjacent to the active electrode(s). Within the ionized gas or plasma, free electrons are accelerated, and electron-atoms collisions liberate more electrons, and the process cascades until the plasma contains sufficient energy to break apart the tissue molecules, causing molecular dissociation and ablation of the target tissue.