Abstract: The present invention relates to a self-expanding endoprosthesis intended to support walls of anatomical channels. The endoprosthesis according to the invention comprises 2n external longitudinal elements, and 2n other intermediate longitudinal elements, distributed in a parallel arrangement about the axis of the endoprosthesis, and offset with respect to one another along the axis, and a plurality of rings distributed about the axis of the endoprosthesis, joining the longitudinal elements and each being in the form of a filament of zigzag configuration. According to the invention, the folded-down configuration of the endoprosthesis is obtained by longitudinal traction of the external elements with respect to the intermediate elements.

Abstract: This invention relates to devices and methods for accessing the spinal epidural space via the neural foramen. In one aspect of this invention a deflecting conduit needle device is disclosed having an elongated body extending substantially along a first axis. The device has a proximal end and a distal end, and a transverse conduit, positioned along the distal one-eighth of the device and extending substantially along a second axis, wherein the second axis is positioned at an acute angle relative to the first axis. In another aspect of the invention a method is disclosed for accessing the spinal epidural space via the neural foramen.

Abstract: Instruments for use in endoscopic carpal tunnel surgery include a cannula having a diameter suitable for passage in the carpal tunnel, a diametrically narrowing open tip to facilitate entry into the carpal tunnel and a matted interior surface to maximize visual clarity of the carpal tunnel display, an obturator having a diameter suitable for passage in the cannula end, a plow shaped tip which laterally shifts tendons and nerves from its path as the tip is passed in the carpal tunnel and a sway-back portion proximate the tip which maximizes the efficiency of the tip as it plows through the carpal tunnel tendons and nerves and a rasp having a rod of diameter suitable for passage in the cannula, a roughened face on an upwardly tapering trapezoidal cross-section tip for guiding penetration of the tip through the longitudinal slot in the cannula but limiting penetration of the tip therethrough, and a bend in the rod so that the roughened face of the tip is in substantially flush alignment with the ligaments when t

Abstract: A suture passing forceps includes an axially elongated support shaft, and a first suture holder for removably holding a needled suture and a second suture holder for capturing the needled suture. The first suture holder includes a suture inlet through which at least part of the suture can be passed. The first suture holder or the second suture holder is an actuatable member which pivots toward an operating position to capture the needled suture in the second suture holder and pivots away from the operating position to remove the suture from the first suture holder. The suture inlet in the suture holder enables complete removal of the suture from the suture holder when the actuatable member and the needled suture move away from the operating position. The second suture holder includes a holding region defined by a contoured surface permitting the needled suture to slide within the holding region.

Abstract: Methods and devices for harvesting veins from the body. The methods and devices allow vein harvesting using laparoscopic procedures. A working space is created over the vein using standard laparoscopic procedures and a side-hooked wire is inserted into the working space and twisted to insert the side-hook under the vein. The wire is then pulled or drawn along the vein to separate the vein from the surrounding tissue. In an alternative embodiment, vein separation is accomplished by threading a soft rubber tube under the vein, grasping the ends of the tube so as to surround the vein, and then pulling the tube along the vein. In other embodiments, the working space is created with everting balloons.

Abstract: An instrument for achieving rapid hemostasis at the conclusion of a catheterization procedure comprises a device for injecting a fluid hemostatic agent into a puncture wound that is operatively associated with a conventional introducer sheath component of the introducer used to gain access to a blood vessel using the Seldinger technique. The hemostatic agent injection device includes a tubular member that can be concentrically disposed with a tubular introducer sheath so as to be slidable therealong and where the injection device includes a hemostatic agent inlet port at a proximal end thereof and an ejection port at a distal end, the two ports being interconnected by a lumen. In a first embodiment, the hemostatic agent injection device is adapted to coaxially surround the introducer sheath and in an alternate embodiment, the injection device is coaxially disposed within the lumen of the introducer sheath.

Abstract: A ring blade and drive system, and method of using same, for harvesting bone-tendon-bone ligament grafts having substantially cylindrical bone plugs. The ring blade disclosed is a circular ring having a predetermined arcuate gap formed in its periphery. The drive system includes a blade holder to peripherally hold the ring blade and a fixed-center oscillating mechanism to oscillate the ring blade about its axis within a predetermined arcuate range of motion. The ring blade structure enables the production of a substantially cylindrical bone plug of unlimited length. Harvesting of a bone-tendon-bone ligament graft is facilitated with the ring blade and method disclosed which enables the ring blade to be placed partially around a tendon segment to create bone plugs aligned with the tendon fibers included in the defined tendon segment. The cuts into the bone may be initiated into the bone at either end of the tendon segment from the tendon side through to the exterior of the bone to which the tendon is attached.

Abstract: A disposable ear-piercing device, ready for immediate use. The disclosure comprises a pair of spaced jaws which receive the earlobe therebetween. One jaw is pre-loaded and carries a piercing pin, while the other jaw is pre-loaded with and carries a locking nut. The jaws are squeezed toward each other in a manner which first causes the earlobe to be gripped and then causes a drive member, carried by the first jaw, to rupture when the jaws are squeezed under a pre-determined force, and to transfer the squeezing force directly to the pin, driving it through the earlobe and into engagement with the locking nut. The pin is carried in a cylindrical barrel and is secured against movement in the barrel by frictional engagement of the periphery of the pin head with a portion of the inner surface of the cylindrical barrel. The functional engagement must be sufficient to secure the pin head against inadvertent movement, but not so much that the pin head will bind in the barrel.

Abstract: The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site.

Abstract: A tubular member is formed from a flat sheet having opposed longitudinal edges. Rows of parallel longitudinal slots are cut in the flat sheet and at least three holes are cut along the opposed longitudinal edges. The holes are aligned with the holes on the opposed edge and sutured together to form the tubular member. The tubular member is compressed over a balloon catheter and thereafter permanently positioned within a desired portion of a blood vessel.

Abstract: A multifunctional spring clip for use in endoscopic and open operative procedures includes a body having opposed portions and a base connecting the opposed portions. Each opposed portion includes an outer segment and an inner segment connected to the outer segment and carrying a grasping surface. The clip is normally disposed in a grasping position wherein the grasping surfaces are biased toward one another, is movable from the grasping position to a receiving position wherein the grasping surfaces are moved away from one another to receive a structure therebetween and is movable from the receiving position toward the grasping position due to the bias to grasp the structure between the grasping surfaces. An applicator for the multifunctional spring clip includes a distal end carrying forceps for engaging the opposed portions of the clip.

Abstract: A tubular suturing device for suturing new types of tubular connectors to the ends of tubular structures such as blood vessels. The suturing device comprises a substantially rigid body containing multiple staples disposed within receptacles arranged radially along a suturing surface of the body, and an actuating mechanism moving in predetermined spaces producing multiple forces ejecting the staples in an approximately radial direction. Various embodiments and methods are provided for attachment of different types of tubular connectors to the external or internal surface of the tubular structures by staples ejected in an inward or outward radial direction; for new methods of clinching of the prongs of the ejected staples; for new surgical procedures and for new instruments facilitating their performance.

Abstract: A balloon catheter is provided which includes a flexible tube on one end of which a balloon is mounted to be inflated by means of the tube, which balloon has an annular restriction in its middle region in a plane approximately perpendicular to the tube axis. The balloon is produced in the form of a bag inside which the end of the tube is engaged, the opening of the bag being fixed to the outer wall of the tube, and the distal end of the balloon projects beyond the distal tip of the catheter tube to provide a cushioning region at the tip of the catheter assembly. A procedure for making the balloon is also described.

Abstract: A stamped clevis is made from a stainless steel sheet which is cut (stamped) to form at least one relatively narrow distally extending arm and at least one relatively broad proximal base. The distal arm is provided with at least one mounting hole for receiving an axle pin and the proximal portion is wrapped to form a cylinder or a broken cylinder. In one embodiment, the sheet is cut to form two relatively broad proximal bases and two relatively narrow substantially parallel distal arms, one arm extending from each base and being provided with a mounting hole. The arms are joined by a cross member proximal of the mounting holes and a central tab having a third mounting hole extends distally from the cross member. The cut sheet is formed by bending the cross member on either side of the tab in an "S" configuration so that the mounting holes are aligned substantially coaxially. The two proximal bases are bent towards each other to form a bifurcated cylinder. The tab may be provided with an integral spike.

Abstract: A set of needles for hands includes a plurality of needles which are arranged and pressured between upper and lower synthetic resin films at regular intervals, in which cutting lines are formed between the needles for hands, and grooves and slant portions are formed at the upper and lower parts of the cutting lines, respectively. Thus, where necessary, each needle for hands can be used by cutting from adjacent ones according to the cutting lines from the grooves. Accordingly, because a set of needles for hands is produced at once, this invention has the advantages of reduction of the manufacturing process, an inexpensive supply and a reduction of the burden of household economy.

Abstract: A suturing instrument (10) is disclosed having a handle (11) with finger rings (16, 17), a surgical needle (14) pivotably mounted to the handle, and grasping jaws (12, 13) for securing the pivotal position of the needle. The needle has a suture receiving recess (26) and a latch (27) pivotable between a closed position overlying the recess and an open positioning unobstructing the recess.

Abstract: A system and method for coupling acoustic energy within a waveguide provides highly efficient and sensitive acoustic energy generation and detection. In particular, an ultrasound angioplasty system is described which makes use of an end-fire array of ring transducers to produce highly directionalized sound within an acoustic waveguide. The transducers can be made circularly symmetric, and may be composed of multiple segments for generating sound waves in independent x and y spatial modes within the acoustic waveguide. Each ring transducer is optimally spaced 1/2.lambda..sub.L from its neighbor transducers, such that alternate transducers transduce 180-degrees out of phase, and may have their electrical end inverted for common drive, or for summing of transducer electrical outputs when the array is used as a detector.

Abstract: A ligating clip having surfaces with slanted ramp members for clamping a tubular vessel. The ligating clip includes a pair of legs, each of which has a proximal end, a distal end and an inner surface. The proximal ends of the legs are joined to define a hinge. The legs may be forced together onto a tubular vessel such that the inner surfaces of the legs are face-to-face in a closed position. A lock tab protrudes inward from the inner surface near the distal end of one of the legs. A lock slot is provided in the inner surface near the distal end of the other leg. The lock slot receives the lock tab to secure the ligating clip in the closed position. A number of ramp members extend angularly inward from the inner surface of each leg in order to keep the tubular vessel from slipping in the distal direction as the ligating clip is closed. A tool for applying the ligating clip is provided with a cutting blade for severing the vessel after the ligating clip has been applied.

Abstract: A method for monitoring cervical dilatation during labor by attaching an ultrasound transmitter and an ultrasound receiver to opposite sides of the cervix and monitoring the input signal to the ultrasound transmitter and the output signals from the ultrasound receiver to provide a measurement of the distance between the transmitter and receiver. The method is characterized in that the ultrasound transmitter produces a divergent ultrasound beam received by the ultrasound receiver. Also provided is an ultrasound transducer device including a clip having a pair of jaws spring-urged to a close position and an ultrasound transducer mounted to one of the jaws, characterized in that the ultrasound transducer has a piezoelectric transmitter surface producing a divergent ultrasound beam.

Abstract: A surgical instrument for cutting tissue, which includes a housing, a cutting element movable between a retracted position disposed substantially within the housing and a deployed position extending outwardly from the housing, a guide member configured and dimensioned to direct orientation of the cutting element, operatively connected to the housing and defining a longitudinal axis, the guide member movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing.