Abstract: A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In a preferred embodiment, the device includes a proximal end and a distal end, and an advancement unit for longitudinally advancing the flexible elongated element toward the distal end of the device such that a proximal end of the elongated element may exit from the distal end of the device with sufficient force to pass through the subject. The device also includes a curved die at the distal end of the device for imparting a looping configuration to portions of the flexible elongated element exiting the distal end of the device, and a curved guide at the distal end for receiving the looped flexible elongated element as it returns to the distal end of the device. In a further feature of the invention, a cutting mechanism is provided to permit the looped flexible elongated element to be separated from the remainder of the flexible elongated element.

Abstract: A fastener preferably made from a shape memory alloy is provided which can access internal tissue or other synthetic material by catheter delivery through an endovascular pathway. After the fastener is deployed through layers of tissue or other material, it assumes a shape that automatically applies to the layers of tissue or other material an appropriate hemostatic compression which is relatively independent of tissue or material thickness. The fastener is a suitable replacement for conventional non bio-absorbable sutures and staples in certain clinical applications. The shape, method of deployment, and low force requirements make the disclosed apparatus suitable for endosurgical procedures where access to the wound site is limited. A method for deploying the fastener is also provided.

Abstract: A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In an embodiment, the device includes a proximal end and a distal end, as well as an advancement unit for longitudinally advancing the flexible elongated element toward the distal end such that a proximal end of the elongated element may pass from the distal end of said device with sufficient force to pass through the portions of the subject. The device also includes a securing unit for variably adjusting a securing force applied by the flexible elongated element to secure together the portions of the subject.

Abstract: A device is disclosed for joining a first layer of material to a second layer of material, the device comprising a handle, a first jaw and a second jaw mounted on the handle, at least one of the first jaw and the second jaw being moveable relative to the other; the first jaw defining therein: a first channel for retaining a wire guide; a second channel extending from the first channel for supporting a suture wire extending from the wire guide; and a passageway for retaining a cutting bar; the second channel being curved to impart a looping configuration to portions of the suture wire passed therethrough; a wire advancing actuator mounted on the handle for moving the suture wire through the second channel and through the first and second layers of material in the looping configuration; and a wire cutting actuator mounted on the handle for moving the cutting bar into cutting engagement with the suture wire, wherein the suture wire in the looping configuration joins the first layer of material to the second laye

Abstract: An instrument for attaching a graft to an aorta includes a first needle assembly for breaching the aorta to provide a hole in a wall thereof, and a carrier portion for insertion of an end of a tubular graft through the hole and into the aorta. Arms are pivotally mounted on the instrument and are moveable from a position extending axially of the carrier to a position extending radially from the carrier to spread the end of the graft radially outwardly from a tubular portion of the graft to form an annular flange extending outwardly from the tubular portion, and to support the flange within the aorta and around the hole therein. A second needle assembly retains the suture material and advances the suture material into engagement with the aorta wall and the graft flange for suturing the graft flange to the aorta wall.

Abstract: An apparatus for placing multiple sutures during anastomosis of physiological vessels includes a crown portion having a plurality of strands connected together by one or more circular bands. The strands each form a point at one end with a curved hook at the same end. The curved hook acts as a suture to retain one or more of the vessels. An alternative embodiment includes a plurality of strands, or wires, that are inserted through one or more vessels to simultaneously place multiple sutures. The present invention also comprises a method for placing a plurality of sutures simultaneously with an apparatus.

Abstract: A suture placer for placing a length of suture wire through tissue such that the suture wire is directed into the tissue and then back out again.

Abstract: A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In a preferred embodiment, the device includes a proximal end and a distal end, and an advancement unit for longitudinally advancing the flexible elongated element toward the distal end of the device such that a proximal end of the elongated element may exit from the distal end of the device with sufficient force to pass through the subject. The device also includes a first curved die at the distal end of the device for imparting a looping configuration to portions of the flexible elongated element exiting the distal end of the device, and a second curved die at the distal end for receiving the looped flexible elongated element as it returns to the distal end of the device. In a further feature of the invention, a cutting mechanism is provided to permit the looped flexible elongated element to be separated from the remainder of the flexible elongated element.

Abstract: A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In an embodiment, the device includes a proximal end and a distal end, as well as an advancement unit for longitudinally advancing the flexible elongated element toward the distal end such that a proximal end of the elongated element may pass from the distal end of said device with sufficient force to pass through the portions of the subject. The device also includes a securing unit for variably adjusting a securing force applied by the flexible elongated element to secure together the portions of the subject.

Abstract: Apparatus for approximating and closing the walls of a hole or puncture in a physiological shell structure which, in one preferred form, comprises a pair of components that manipulate wire suture. The first component, sometimes referred to herein as a suture introducer, locates the edges of the hole and passes wire suture through them. The second component, sometimes referred to herein as a suture tensioner, gathers the free ends of the wire suture and twists them together, which in turn closes the hole. After the wire suture has been twisted sufficiently to effect closure, the excess wire is trimmed away. The apparatus can deploy more than one wire suture at a time if desired. Using self-locating features and tactile feedback, the apparatus is particularly well adapted to access remote surgical sites.

Abstract: A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In an embodiment, the device includes a proximal end and a distal end, as well as an advancement unit for longitudinally advancing the flexible elongated element toward the distal end such that a proximal end of the elongated element may pass from the distal end of said device with sufficient force to pass through the portions of the subject. The device also includes a securing unit for variably adjusting a securing force applied by the flexible elongated element to secure together the portions of the subject.