Abstract: Apparatus is provided for implanting a prosthetic device (108) in a patient, the apparatus includes a trocar tube (101), a first portion of which is configured to be placed in a left ventricle (12) of the patient during a procedure for implantation of the prosthetic device (108), and a second portion of which is configured to be placed in an extracardiac location during the procedure. The first portion is shaped so as to define at least one opening to an interior thereof. One or more flexible bypass tubes (103, 104, 106), each of which is coupled to the second portion, and each of which is configured to be coupled to at least one artery (20, 21, 30) of the patient, so as to create a blood flow bypass path during the procedure, from the left ventricle (12), via the opening and the bypass tubes (103, 105, 106), to the at least one artery (20, 21, 30). Other embodiments are also described.

Abstract: A proctological instrument is disclosed comprising an instrument handle to which at its proximal end a bending-resistant tubular shaft is mounted at the distal end of which a cap is fixed or formed to which a tissue clip adapted to be withdrawn from the cap by means of a releasing or withdrawing device is attached in a preferably spring-elastic manner. In accordance with the invention, the tubular shaft is offset at its distal end portion in an area directly ahead of the cap and/or the cap itself is offset at a predetermined fixed angle so that the withdrawing direction for the clip defined by the cap is aligned at the angle with respect to the tubular shaft axis.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a ligation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a ligation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This ligation element placed from the esophagus and around the Angle of His to create a barrier to gastroesophageal reflux.

Abstract: A method of connecting a suture to a bone including the steps of inserting at least one suture anchor into the bone, and disposing a suture loop about a crossbar of the suture anchor in such a way that when a proximally directed force is applied to the suture loop, a free end of the crossbar engages a transverse edge of the body of the suture anchor to limit proximal motion of the crossbar and capture the suture loop.

Abstract: Subcutaneous sinusoidal wound-closure techniques use one-way sutures. The one-way sutures have tissue-grasping surface features which allow passage of the suture in one direction through tissue, but not in the opposite direction. In closing a wound, the one-way suture is deployed along a curvilinear path which passes alternately through subcutaneous tissue on opposed sides of the wound. The wound-closure techniques allow approximation of the sides of the wound without knots, avoid loop stitching and reduce scarring.

Abstract: A device and method for deploying a mechanical closure device for closing a passageway in a body, for example a patent foramen ovale (PFO) in a heart. The deployment device has a first tubular structure having proximal and distal ends. A second tubular structure is substantially coaxial to and slideably engaged within the first tubular structure. The second tubular structure has a first substantially linear shape when constrained within the first tubular structure, and a second curvilinear shape when telescopically extended from the distal end of the first tubular structure. A third tubular structure is substantially coaxial to and slideably engaged within the second tubular structure. The third tubular structure is configured to provide sufficient rigidity to push the mechanical closure device from the distal end of the second tubular structure, and provide sufficient flexibility to assume a curvilinear shape when deflected by the second tubular structure.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions through which a ligation is placed and secured into tissue. An objective of this invention is to provide a stable securement platform for the coupling of secondary anchors to the gastrointestinal tract. Specifically, endoscopy is used to insert an anchoring element through the walls of adjacent body cavities. The ends of the anchoring element are coupled together to form a loop. This anchoring element can be used to secure other anchors or devices to the gastrointestinal tract.

Abstract: Endoscopic methods utilize self-retaining sutures to approximate tissue in a cavity of a subject. An endoscopic instrument is provided containing the self-retaining suture. The endoscopic instrument may be provided in combination with an endoscope and/or an endoscopic manipulator. The endoscopic instrument is passed through a cavity wall into a cavity of a patient. The self-retaining suture is deployed, using the endoscopic instrument, into a first tissue portion and a second tissue portion within the cavity. The self-retaining suture may be deployed endoscopically in patterns which include, purse string stitch, alpha stitch, linear stitching, curvilinear stitching, continuous helical stitch, and continuous sinusoidal stitch.

Abstract: A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.

Abstract: Medical devices and methods for making and using the same. An example medical device may include an elongate tubular member, an endosurgery stent disposed on the outer surface of the tubular member, a push tube slidably disposed along the outer surface of the tubular member, and a push member slidably disposed in a lumen formed in the tubular member. The push member may be coupled to the push tube.

Abstract: A method for joining and holding closed a wound in bodily tissue, fastening junctions of wounds, tying off wounds, joining a foreign element to tissue, and altering the position of tissue using a barbed suture including sharp pointed ends. Each end of the suture includes barbs on that permit movement in an opposing direction to the barbs on the other end of the suture. This two-way barbed suture is used by the method of the present invention in applications including abdominal surgeries such as a Nissen fundoplication, laparoscopic uses such as stabilizing a bowel structure and performing a closure of a cystostomy, liver to bowel anastomosis, closure of an orifice of a Zenker's Diverticulum, endoscopic uses such as closure of ulcerative lesions or and post-procedural tissue defects, bladder wound closure, valve replacement surgery, device attachment, cosmetic surgery, and blood vessel wound closure.

Abstract: An anastomosis procedure utilizes a self-retaining suture to secure one vessel to another vessel. One or more self-retaining sutures are deployed around the interface between the vessels. The self-retaining sutures have tissue-grasping surface features which allow passage of the sutures in one direction through tissue, but not in the opposite direction. The self-retaining sutures may be deployed using a needle attached to the end of the sutures. The anastomosis technique may be performed without using knots.

Abstract: An insert-molded suture anchor with a biodegradable polymer body in which a loop of suture is totally contained within the polymer. The suture anchor body features a drive end that is shaped to be received into a recess in the end of a hand driver. Anchoring ribs are formed along the remaining length of the anchor. The loop of suture which includes and eyelet for attaching a suture strand is totally embedded within the anchor body during the insert-molding fabrication process. The anchor is produced by placing the suture in an injection mold, and injecting biodegradable polymer into the mold.

Abstract: An implant for occluding a passage in a circulatory system of a human body comprises elongate members (1) which can be twisted into fixation structures and at least two occluding bodies (2, 2?) being attached to the elongate members (1) and being arranged at a distance to each other. This implant combines the advantages of a single occluding body implant with the advantages of a double occluding body implant.

Abstract: The present invention relates generally to a device and method for preventing the undesired passage of emboli from a venous blood pool to an arterial blood pool. The invention relates especially to a device and method for treating certain cardiac defects, especially patent foramen ovales and other septal defects, through the use of an embolic filtering device capable of instantaneously deterring the passage of emboli from the moment of implantation. The device consists of a frame, and a braided mesh of sufficient dimensions to prevent passage of emboli through the mesh. The device is preferably composed of shape memory allow, such as nitinol, which conforms to the shape and dimension of the defect to be treated.

Abstract: A system and a method of performing a frameless image-guided biopsy uses imaging, a six-dimensional robotic couch system, a laser guidance system, an optical distance indicator, and a needle control apparatus. A planning CT scan is made of the patient with stereotactic fiduciary markers to localize and produce digitally reconstructed radiographs. Two stereoscopic images are generated using an imaging device to visualize and identify a target tumor. The images are fused with the digitally reconstructed radiographs of the planning CT scan to process tumor location. The tumor location data are communicated to the movable robotic couch to position the target tumor of the patient at a known isocenter location. A biopsy needle is guided with a laser alignment mechanism towards the isocenter at the determined depth using a needle positioning apparatus and an Optical Distance Indicator, and a biopsy sample of the target tumor is obtained.

Abstract: An improved system for mammography analysis and methods of using the same. In one aspect, a clip comprises a first portion and at least one additional second portion connected to the first portion, the first and second portions adapted for elastic deformation for engaging tissue. In anther aspect, an improved actuator for performing a breast biopsy is used to deploy a clip. In yet another aspect of the invention, there is contemplated a system for marking an evacuated breast cyst.

Abstract: The present invention generally provides devices and methods for tensioning a length of suture. In one embodiment, a suture tensioning device is provided having a shaft and a suture grasping member. A knotting element can be removably coupled to a distal end of the shaft, and it can be adapted to receive a suture and to lock to engage the suture. The suture grasping member can be movably coupled to the shaft and configured to grasp a suture and pull it through the knotting element to allow the knotting element to lock and engage the suture.

Abstract: A clip for securing suture to tissue includes a generally tubular body, with at least one bend area along the length of the generally tubular body and one or more tabs cut from the wall of the generally tubular body. The clip in the open configuration is generally straight along the length of the generally tubular body, and the tabs are in general alignment with the tab out wall. The tab in a closed configuration assumes a shape having at least one bend along its length, and the tabs are bent or otherwise positioned to extend into and at least partially obstruct the inner lumen. The clip can be formed from memory material such as nitinol, and the clip may be biased toward its closed configuration.

Abstract: The present invention provides a device which is adapted to press together the septum primum and the septum secundum between the atrial chambers to close any tunnel in the septum. The device in its preferred form has two clamping members, one on each side of the septum and a central connector which connects the two clamping members and passes through the tunnel. The device is configured to conform to the anatomy such that the tunnel is not substantially deformed by the device. The central connector, in its preferred form has two wires that are spaced apart so that the wires are proximate the lateral sides of the tunnel. The spacing allows the device to be centered at an appropriate location.