Abstract: The present invention provides devices for safely closing an opening in tissue using suture. In one embodiment, the device includes an elongated main body constructed to permit visualization longitudinally through the main body from the proximal end to the distal end, the distal end defining a support surface to support the suture and protect distal body structures. A flange is connect to the main body adjacent the proximal end and projects laterally therefrom in first and second lateral directions. First and second guide holes extend longitudinally through the flange, and are structured to direct a suturing instrument longitudinally towards the support surface for passing the suture.

Abstract: A system for treating a bifurcated vessel that includes a first delivery catheter and a second delivery catheter. The first delivery catheter carries a proximal first stent and a distal second stent. The first delivery catheter also has a first elongate shaft, a proximal first expandable member with the proximal first stent disposed thereover, and a distal second expandable member with the distal second stent disposed thereover. The proximal first expandable member and distal second expandable member are independently expandable of one another. The second delivery catheter carries a third stent. The second delivery catheter also has a second elongate shaft, and a third expandable member with the third stent disposed thereover. The third expandable member is independently expandable of the proximal first expandable member and the distal second expandable member.

Abstract: A leadless implantable device delivery apparatus that enables testing of an implantation site before permanent implantation and enables secure attachment at the site while minimizing effects of the implantation procedure. Embodiments include a delivery sheath configured to accommodate a leadless implantable device, the leadless implantable device having an anchor that includes at least one projection configured to physically attach the anchor to tissue, such as heart tissue. In addition, embodiments include an adapter that resides within the delivery sheath and is configured to impart rotational force at the distal end of the adapter that is applied to the proximal end of the adapter to rotate the anchor associated with the implantable device.

Abstract: A technique for joint repair employing a suture/button construct and an applicator designed to securely engage a button of the suture/button construct. The button of the suture/button construct securely engages two shafts of the applicator (i.e., an angled, non-vertical flat face of the outer shaft and a threaded region of the inner shaft). Engagement to and disengagement from the applicator is conducted without rotation of the button. The applicator with the secured button is introduced into the tissue (for example, soft tissue or a bone tunnel) and the button is passed through the tissue.

Abstract: A surgical clip includes a pair of opposed arms joined at one end by an integrally formed flexible hinge and a hinge lock. A male head element near the free end of one arm is configured to spread tissue when the male head element is urged towards a head mating element near the end of the opposite arm. The clamping side of an arm may include a protruding feature, such as a wedge shape elongated ridge, while the clamping side of the opposite arm includes a corresponding trough or aperture that receives the protruding feature. Clamping surfaces may include non-slip protrusions, such as ribs, ridges, cones or pins. An applicator holding feature, such as a boss, near the hinge prevents the clip from yawing and becoming askew during application.

Abstract: A system for performing angioplasty and a method of utilizing same are provided. The system includes a balloon mounted on a catheter shaft and an expandable constraining structure mounted over the balloon. The expandable constraining structure includes a plurality of axial struts crossing a plurality of radially-expandable rings being for constraining said balloon such that isolated balloon regions protrude through openings in said constraining structure when the balloon is inflated.

Abstract: An implant manipulator may have a distal end that retains an implant, a proximal end, and an intermediate portion between the ends. The intermediate portion may have a cross-sectional shape that extends along a nonlinear pathway. The intermediate portion may have a selectively bendable portion in which the cross-sectional shape varies to facilitate bending when desired. The implant manipulator may be a needle for a suture passer, with a suture capture feature at the distal end. The suture capture feature may have first and second members that flex apart to permit entry of the suture into a suture capture hole wherein the suture is retained until released. A suture passer may receive the needle in a bore shaped to change the cross-sectional shape to facilitate or restrict bending of the needle, as needed.

Abstract: A constraining structure for use with a balloon catheter can include multiple longitudinal struts and multiple, sinusoidal shaped radial rings. The constraining structure can expand to form a pattern of channels including substantially square windows. The constraining structure can modify, restrict, and control a shape and/or size of the balloon when inflated. Inflating the balloon catheter within the constraining structure can provide nonuniform pressure on a vessel wall adjacent the balloon.

Abstract: An endoscopic instrument is provided and includes a housing including an elongated shaft assembly extending distally therefrom. The elongated shaft assembly includes inner and outer shaft members. The inner and outer shaft members are removably coupled to the housing and the outer shaft member is movable with respect to the inner shaft member. An end effector is operably supported at the distal end of the outer shaft member and includes a pair of jaw members configured for treating tissue. A bushing operably couples to the inner and outer shaft members of the shaft assembly and selectively and releasably couples to the housing. The bushing includes one or more mechanical interfaces configured to engage one or more slots defined through the inner shaft member and one or more slots defined through the outer shaft member to release the inner and outer shaft members from the housing.

Abstract: A device and a method for sealing an opening in the wall of a blood vessel is provided. The device includes an automatic mechanism, a shaft fixedly connected to the automatic mechanism, a seal assembly attached to the distal end of the shaft, and a pushing rod also engaging the seal assembly, the automatic mechanism moving the pushing rod from a first position to a second position in response to the shaft being pulled distally a predetermined distance.

Abstract: A suture retention device is provided for retaining a suture. The device has a locked state and an unlocked state. In the locked state, a spring biases a first gripping surface and second gripping surface together to enmesh a suture to prevent the suture from sliding through the device. In the unlocked state, an actuator may be engaged to bias the spring and separate the first and second gripping surfaces to allow the suture to freely slide through the device.

Abstract: An elastic band ligation device for treatment of hemorrhoids including an inner tubular member for retaining a stretched elastic band over the front end thereof, a plunger in the inner tubular member with a handle for sliding the plunger to generate a suction for drawing hemorrhoidal tissue into the inner tubular member. An obturator connected to the plunger is provided within the inner tubular member. An outer tubular pusher sleeve with a limited friction fit is provided over the inner tubular member, the end of outer tubular pusher sleeve being adjacent the stretched elastic band. The outer pusher sleeve has a thumb pusher to allow the operator to push the outer pusher sleeve towards the front end of the inner tubular member or to secure the outer pusher sleeve and withdraw the inner tubular member, which deploys the elastic band on the hemorrhoidal tissue.

Abstract: Provided is a tissue excision method that excises a partial tissue within an excision region set in a hollow organ over an entire thickness direction. The tissue excision method includes a first process of gripping a peripheral edge portion of the excision region from the inside of the hollow organ; a second process of moving the portion and drawing the folded hollow organ into a slit with a predetermined width; a third process of suturing a part located outside the excision region so as to be integral over the thickness direction; and a fourth process of cutting the portion of the drawn hollow organ along the peripheral edge of the excision region. In the second process, a portion of a fluid within the hollow organ is moved out of the hollow organ to keep the internal pressure within a fixed range while drawing the portion of the hollow organ.