Abstract: The invention relates to a tissue anchor which is an open helix of biocompatible material having a slope of from 0.5 to 10 turns per centimeter, a length from 3 to 75 millimeters, a diameter of from 1.5 to 11 millimeters, and an aspect ratio of from about 3 to about 5 to 1. The anchor can have a head which is capable of securing or clamping tissue together, such as holding a suture to secure a ligament or tendon to bone. The anchor can also have a head which causes an inward, compressive loading for use in fastening bone to bone, orthopedic plates to bone, or cartilage to bone.

Abstract: A surgical instrument for holding a suture needle is disclosed. The instrument is of scissors configuration with elongated arms having finger loops at one end and jaws at the other end to grasp a suture needle. This improved instrument has specialized jaws containing a transverse channel that securely holds a suture needle at a right angle to the axis of the needle holder. The width of the transverse channel automatically adjusts to the size of the suture needle as it is being placed in the needle holder. This improved configuration significantly reduces the long standing problem of suture needle twisting or rotation in the needle holder jaws as the surgeon passes the needle through tissue.

Abstract: A ligative suturer according to the present invention comprises a first rod which is connected with a ligative sutural member, and a second rod which is connected with the first rod to be bendable in the horizontal direction (L, R). A thread guard member which is capable of protrusion and storage is provided in the first rod, while a lever which can select the bending direction of the first rod in response to the situation of employment by an operator is provided in the second rod. Due to this ligative suturer, the operator can regularly bend the first rod toward him whether he handles the suturer with his left or right hand.

Abstract: A knotless suture anchor assembly for the attachment or reattachment or repair of tissue to a bone mass. The assembly allows for an endoscopic or open surgical procedure to take place without the requirement of tying a knot for reattachment of tissue to bone mass. A spike member is inserted through tissue mass through a loop and inserted into a dowel-like hollow anchoring sleeve which has been inserted into a bone mass. The spike member is securely fastened or attached to the anchoring sleeve with a ratcheting mechanism thereby pulling or adhering (attaching) the tissue to the bone mass.

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: Disclosed is a device for delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or other animal. Also disclosed is a method of delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity. The method is particularly suited to sealing perforations in vascular walls, such as after arterial access for Percutaneous Transluminal Coronary Angioplasty (PTCA), Percutaneous Coronary Angiography and Percutaneous Coronary Atherectomy and similar diagnostic and therapeutic procedures.

Abstract: A purse string suturing instrument is provided for quickly and effectively forming a purse string suture in tubular tissue through relatively small cannulas placed in the body. The instrument includes a pair of elongated jaws, each having a row of spaced-apart uniform-size teeth. The jaws are hinged together at one end to clamp the tubular tissue therebetween. The two rows of teeth are offset with respect to each other so that they mesh when the jaws are closed. The jaws are inserted through a cannula and positioned to close around the tissue to be sutured. The rows of teeth then bend the tissue between them into a wavelike configuration. A pair of needles, the ends of each being connected to a single length of suture, is then inserted through passageways provided through the teeth. An encircling series of stitches are thus formed in the wall of the tubular tissue to create a purse string suture. The needles and the suturing instrument are then withdrawn through the cannula.

Abstract: A bioabsorbable assembly for sealing an incision or puncture in the body of the patient including a first member which is positioned generally along the wall of the blood vessel, duct, body cavity or lumen of the patient and a gelatinous material which is injected into the incision or puncture around a filament or clip member which is associated with the first member to seal the incision or puncture from the flow of fluids through the blood vessel, duct or lumen of the patient and the method therefore.

Abstract: A device for promoting hemostasis in a blood vessel puncture is employed with an introducer that accesses the puncture through an incision. The introducer has an open distal end positionable at the puncture, an external portion with an open proximal end, and an axial channel therebetween. The device includes a hollow catheter, dimensioned to pass through the introducer channel, having a distal end to which is attached an expansible compression element, which may be an inflatable balloon, a collapsible prong assembly, or a resilient foam pad. The compression element is collapsed when the distal end of the catheter is enclosed within the introducer. When the catheter and the introducer are located the desired distance from the puncture, the introducer is displaced axially relative to the catheter to expose the compression element to the subcutaneous tissue, whereupon the compression element is expanded.

Abstract: A surgical plug and method are disclosed for minimizing leakage of insufflation fluid from an inflated body cavity through a puncture opening during an endoscopic surgical procedure. The surgical plug and method can be used to maintain insufflation during an endoscopic surgical procedure. The surgical plug includes a cap to plug the puncture opening and seal it, and a shaft extending from the cap into the body cavity. The shaft has helical thread, and the shaft is screwed into and through the opening until the cap is adjacent the body wall through which the opening is made. The surgical plug is stable and can maintain its sealing effect throughout an entire endoscopic surgical procedure. It also does not obstruct or interfere with the field of vision at the surgical site within the body cavity during the procedure. The method of using the surgical plug is simple and straightforward.

Abstract: A suturing device includes a handle and an elongate needle having a hollow lumen. The needle is insertable percutaneously to form a suture around tissue portions within a body cavity. Initially the needle is inserted through the tissue portions and one end of a suture is deployable through the lumen of the needle by operation of the handle. The needle can then be retracted leaving the suture extending through the tissue portions. A snare also positioned within the lumen of the needle is deployable by operation of the handle to engage and capture the free end of the suture. Both ends of the suture can then be removed and a slip knot tied to form the suture. The snare can be formed in a hook configuration and maintained in a particular plane as it is deployed and retracted. This enables the hook to be guided back into the lumen in order to capture the free end of the suture line and facilitate retraction of the suturing device.

Abstract: A medical instrument performs at least one of suture and ligation to form a suitable knot in a piece of suture within a body cavity. This medical instrument includes a suture having a first end portion, a second end portion, and at least one loop formed in advance at an intermediate portion between the first and second end portions to have a predetermined size, and a suture suitable for application to a body tissue, and a cylindrical body for holding the loop to almost maintain the size thereof. The body has a fastening portion for fastening at least one portion of the suture. The medical instrument further includes an inserting instrument which is to be inserted into the body cavity, which has a distal end portion that can be arranged in the body cavity, and an operating portion, arranged outside the body, for operating the distal end portion thereof, and on which a holding member having the suture wound thereon is mounted.

Abstract: An apparatus for use in arthroscopically attaching a suture to bone comprises a cannula and drill guide for use in drilling parallel holes in the bone and a scissors-like component for carrying a suture down one hole and pushing the suture through soft bone into the other hole where it can be retrieved.

Abstract: Surgically implantable hernia mesh patches are available in several embodiments, wherein each embodiment has double like size layers of inert synthetic mesh material, compressibly positioning an internally positioned loop of a resilient monofilament fiber, when these double layers of mesh are sewn together around their edges, while leaving one centimeter free of both top and bottom layers of mesh. During operating time of a surgical repair of an inguinal hernia, one of these hernia mesh patches is compactively arranged and then inserted through a relatively small incision, for subsequent planar expansion and directed placement to where the hernia is, usually under minimal anesthesia, without the need for entering a patient's abdominal cavity, and without the need to use instrumentation, such as laparoscopic equipment.

Abstract: An improved device and method for suturing penetrations and incisions through tissue into a body cavity. The device should find particular use in laparoscopic and other types of minimally invasive surgical procedures. A device according to the invention includes a shaft and an inverted needle joined to the shaft. Two ends of a length of suture material are attached at or near a sharpened proximal tip on the needle. The device may include a movable shield that is slidable to alternately cover and expose the sharpened tip of the needle. This shield may include a blunt distal end and an inclined proximal surface to assist the surgeon in guiding the hook into and out of the body cavity. The device may be provided with a visual and tactile indicator on one side of the device to assist the user in threading and removing the suture material into and out of a selected side of the hook.

Abstract: A device for sealing incisions in the body of a patient wherein the device includes a bioabsorbable sealing member having an elongate shaft member and an elastomeric and flexible balloon member. The device may also include a preformed or injectable collagenous material associated therewith to hemostatically seal the incision in the body of the patient. The shaft member may include one or more lumens extending therethrough in flow communication with one or more balloon members thereon to provide a relatively simple device which effectively seals an incision in the body of a patient.

Abstract: The present invention pertains to a magazine that is loaded with a needle and an attached length of suture pre-tied in a knot on the magazine. The magazine is used in loading the needle onto a stitching surgical instrument and in loading the tied length of suture onto a suture tying surgical instrument.

Abstract: A surgical instrument for holding a needle, which instrument has first and second elongate jaws movable selectively towards and away from each other between a) an open position in which a needle can be placed between the jaws and b) a closed position in which the jaws can captively embrace a needle. A structure, and preferably a sleeve, is movable lengthwise relative to and against at least one of the first and second jaws between first and second positions to thereby move the jaws between their open and closed positions. There is a seat on one of the first and second jaws for reception of a needle to be held by the surgical instrument and a cam surface on the other of the first and second jaws for wedging a needle in the needle seat in the one of the first and second jaws as an incident of the jaws being moved from their open position into their closed position to thereby positively hold a needle in an operative position on the needle holding instrument.

Abstract: A medical instrument for placement of a knot, in particular, for operating within closed spaces. With the use of such instrument, the thread can be held, guided and/or manipulated at least on one side of the knot and adjacent thereto by an instrument head in such a way that the knot can be pushed into the vicinity of a target point and placed exactly in the target point by spreading at least one free end of the thread.

Abstract: An endoscopic clip applying system as described which contains a venting system and a clip applying support system which prevents closure of the mechanism before firing. Also, the system ensures proper loading of the clips and prevents them from falling out during loading. Further, the system describes an easily manufacturable, positively opening system which has minimized size requirements. Furthermore, a lock-out mechanism is provided so that the mechanism may not be inadvertently fired. The shaft resists excessive torque as well as holds the clip in place during firing. There are provisions for sealant and non back-up of the clips, as well as features which make the clip properly placed for closure.