Abstract: A tool is described which is useful for tightening a band or ligature having a buckle end and a free end during laparoscopic surgery. The tool comprises outer and inner elongate, slidably mounted cylindrical members. The outer member, which is slotted, has mounted on the distal end thereof a member for grasping the buckle end of a ligature. The inner member has a grasping portion mounted thereon and projecting through a slot in the outer member which is suitable for releasably engaging the free end of the ligature. In practice, the free end of the ligature is brought around to encircle a tissue and passed through a conduit within the buckle portion of the ligature, much as one threads a belt end through a buckle prior to cinching tight and fastening. The buckle portion preferably has a tab projecting therefrom with a hole therein which accommodates the buckle grasping member on the end of the outer member.

Abstract: An inflatable envelope and a procedure for using it for the purpose of elongating tubular or linear tissue during the acute phase of a surgical procedure. The envelope has a path upon which the tissue is aligned, whose path length increases with inflation of the envelope. Successive inflations and deflations result in elongation of the tissue enabling re-connection of ends of the tissue which before were significantly spaced apart.

Abstract: A reversible gastric banding device for creating a stoma opening in the stomach for restricting food intake into the lower digestive portion of the stomach. The band is operatively placed to encircle the stomach. Once in position, it is held securely with sutures on the outside of the stomach thereby prohibiting the encircled stoma opening from expanding. If, following implantation, it becomes necessary or desirable to remove the gastric band, a remotely actuated releasing portion permits the removal of the gastric band without major surgery. In one embodiment, the banding device is conveniently removed by means of a retractable blade within the band which blade, when retracted by remote activation, severs the retaining sutures and frees the band for removal.

Abstract: An improved inflatable longitudinal expander used in reconstructive surgery for lengthening soft tissue. A retaining disk, a central portion of which is affixed to the top of an inflatable expansion chamber, wraps around and securely holds the soft tissue to be expanded. The retaining disk is fastened in place with a single suture. Once the soft tissue is safely enclosed within the envelope formed by the retaining disk, the tissue expander is inflated with saline solution injected through a self-sealing injection port causing the inflatable expansion chamber to expand and the soft tissue to be stretched and lengthened. The expander, which may be used intraoperatively or implanted for interoperative use, is particularly adapted for either short or long-term stretching of tubular or linear tissues such as blood vessels, fallopian tubes or nerves.

Abstract: An improved injection reservoir for medically implantable devices is disclosed, the improvement means for (a) verifying that the tip of the needle is actually in the injection reservoir prior to injection; and (b) reducing damage to the needle tip during the verification procedure. In the preferred embodiment flexible needle guard provides first contact with a needle entering the reservoir. Further pressure on the needle results in movement of the needle guard causing brushes attached thereto to slide against a roughened surface housed within the reservoir causing a mechanical vibration which can be either felt with the fingers via transmission up the needle or heard with a stethoscope placed on the skin in the vicinity of the reservoir. The surface of the flexible needle is coated with a layer of hard biocompatible elastomer to further reduce damage to the needle tip during position verification.