Abstract: Tissue management methods can include inserting a clamping device into a vessel and clamping a vessel wall via the clamping device. Tissue can be dilated about the clamping device and an anastomotic device provided to the vessel.

Abstract: An apparatus and method for using an anastomosis device to repair severed tissues resulting from a surgical medical procedure such as a radical prostatectomy, ilio-orthotopic neobladder construction, cystoprostatectomy, cystectomy, urethral anastomosis, or ureteral anastomosis.

Abstract: A gastroplasty method involves a staple line that terminates prior to reaching the gastroesophageal junction such that the bypassed portion of the stomach does not require resection. Additionally, bougies are taught that assist a physician in following the improved staple line of the present invention.

Abstract: A seal element for sealing between tissue lumens includes a first material for allowing tissue ingrowth and a second sealant material.

Abstract: A system including an implantable fastener for fastening layers of tissue is disclosed. In one embodiment, the fastener includes a proximal anchor member and a distal anchor member each being movable from a reduced profile position to a deployed position. The anchor members are mesh structures capable of moving to the deployed position by reducing the axial spacing between opposite ends of the anchor members. Methods of treating gastroesophageal reflux disease (GERD) are also disclosed. One of the methods includes placing the distal anchor member through a hole formed in the wall of the esophagus and through a hole formed in the gastric wall. The distal anchor member and the proximal anchor member are then placed in their deployed positions to fasten the wall of the esophagus and the gastric wall together between the anchor members.

Abstract: A method of deforming a plurality of surgical fasteners is provided. The method includes the step of providing a surgical instrument having a loading unit supporting the plurality of surgical fasteners in an array, the surgical instrument having a handle, a distal link, an intermediate link, and a proximal link. The method further includes the steps of moving the handle in a direction to pivot the intermediate link to a position in which the distal link, intermediate link, and proximal link have a fully-extended position, compressing a spring disposed adjacent the proximal link, deforming the surgical fasteners, moving the handle further in the direction, pivoting the intermediate link to another position in which the distal link, intermediate link, and proximal link have a deflected position and releasing the surgical fasteners from the loading unit.

Abstract: An exemplary surgical staple may include a base including a first end and a second end; a single tine extending from the second end of the base; and a barb extending from the base at a location between the first end of the base and the second end of the base. An end of such a staple may be frangibly affixed to a feeder belt. Another exemplary surgical apparatus may include at least one staple including a base including a first end and a second end, a first tine extending from the second end of the base, and a second tine extending from the base at a location between the first end of the base and the second end of the base.

Abstract: A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Abstract: This tissue fastening apparatus is a tissue fastener for clamping first biological tissue and second biological tissue so as to be in close contact with each other, including: a first tissue fixation portion, made of an elastic wire wound in a coil, that is locked on the first biological tissue; and a second tissue fixation portion, made of an elastic wire wound in a coil, that is locked on the second biological tissue, the second tissue fixation portion continuing into the first tissue fixation portion, in which when falling off first and second biological tissue necrotized by being clamped between the first tissue fixation portion and the second tissue fixation portion, the tissue fastener moves only from the second tissue fixation portion to the first tissue fixation portion side and falls off.

Abstract: A vascular graft includes a flexible conduit including a sidewall defining a cavity extending between a first end and a second end. The first end includes an opening that is oriented substantially perpendicular to a centerline axis of the conduit. The second end includes a end wall and a tapered portion extending from the sidewall to the end wall such that the cavity includes a first diameter defined at the first end and a second diameter defined at the second end that is smaller than the first diameter. A lateral opening extends through the sidewall and is oriented substantially parallel to the centerline axis. The lateral opening positioned near the second end and is sized to provide flow communication between the cavity and a blood vessel.

Abstract: A medical device, system and method tor an open surgical procedure configured to couple, for example, open ends of anatomical structures. The system includes an expandable tubular structure and inflatable balloon positioned within the tubular structure. The tubular structure includes a lateral opening defined in a wall of the tubular structure through which the balloon is inflated to radially expand the tubular structure, after which the balloon is deflated, and then removed from the tubular structure to, thereby, provide a fluid flow path through the tubular structure.

Abstract: Described are medical devices which are or can be used to form tubular medical devices, and related methods. Preferred devices include tubular grafts of biomaterial having lumen walls which present no seam edge that traverses the entire length of the lumen, illustratively including devices having lumen walls which have a discontinuous seam presenting multiple seam edges. Such a device may include a tubular structure formed by inserting a plurality of extensions of a biomaterial sheet through a plurality of corresponding apertures of the sheet.

Abstract: According to the disclosure, a variable tissue volume circular stapler instrument (9) may be adapted from those currently used for the removal and treatment of haemorrhoids. An exemplary instrument comprises a handle, a shaft extending from the handle, and a stapling head assembly extending from the shaft. The stapling has a hollow casing that allows a certain amount of tissue to be drawn into the housing via the use of draw string sutures placed in the mucosal layers of the anal wall. The amount of tissue drawn into the housing with current instrumentation may be controlled by providing a variable tissue-volume control mechanism (16) mounted between the casing, the staple pusher mechanism (15) and the central shaft (19) and having fenestrations (18) which correspond to external stapler housing fenestrations (17).

Abstract: An endoscopic treatment tool according to the present invention is an endoscopic treatment tool which is inserted into hollow organs via the mouth, nose, anus, or other natural orifice of the patient and performs suturing treatment within the hollow organs or abdominal cavities, includes: a hollow organ lining support which is smaller than the smallest diameter of a passage from a natural orifice of the hollow organ, the hollow organ lining support being able to expand so as to have a diameter larger than the smallest diameter of the passage from the natural orifice of the hollow organ.

Abstract: Devices, systems and methods are disclosed for the formation of an arteriovenous fistula in the limb of the patient. Embodiments include a device for the creation, modification and maintenance of a fistula that includes an integral fistula creation assembly near its distal end that passes through the skin of the patient, through a first vessel such as an artery, and into a second vessel such as a vein. The fistula creation assembly preferably includes an anastomotic implant that is placed within the fistula to maintain long-term blood flow therethrough. The devices, systems and methods can be used to treat patients with one or more numerous ailments including chronic obstructive pulmonary disease, congestive heart failure, hypertension, hypotension, respiratory failure, pulmonary arterial hypertension, lung fibrosis and adult respiratory distress syndrome.

Abstract: A shunt rivet for implantation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease.

Abstract: An assembly includes a stabilizer and an instrument to be positioned in or around a passage surrounded by body tissue, in particular vascular tissue. The stabilizer is provided with a loop-shaped suction nozzle, which nozzle can be operationally connected to suction elements in order to suck tightly to tissue close to and around the passage. The instrument has a head section for performing operations on vascular tissue.

Abstract: The tissue approximating structures for the anastomosis devices of the invention preferably include two sets of approximating structures or tines spaced from each other along the length of a catheter body that can be extended and retracted from the catheter body. Each of the sets of tissue approximating structures is preferably sequentially deployable in such a way that the surgeon can activate a first set of tines to engage a first tissue structure, verify that an adjacent second tissue structure is properly positioned relative to the first tissue structure, then activate a second set of tines to engage that adjacent second tissue structure. Each of the sets of tines is preferably controlled by a single actuation mechanism that is attached to the anastomosis device and is positioned outside the patient's body.

Abstract: A device is disclosed that provides for the protection of intestinal anastomosis sites and other body sites from bodily fluids and contaminants. Additionally, the device provides the ability to create negative pressure at the site of the obstruction to ensure that contaminants flow from the visceral compartment into the inner lumen of the bowel. Further, the device provides the sectional forces through natural constrictions of the intestinal muscles through peristaltic action.

Abstract: A medical graft connector for connecting an end of a tubular graft conduit to a side wall of a patient's existing tubular body conduit via an aperture in the side wall thereof has a first plurality of fingers configured to engage an interior surface of the side wall of the existing conduit. A second plurality of fingers is configured to engage an exterior surface of the side wall of the existing conduit. A third plurality of fingers is received in an interior lumen of the graft conduit, and a fourth plurality of fingers is configured to pierce the graft conduit. The connector is radially deformable between a first size and a second size.

Abstract: The present invention includes a method and apparatus for adhering tissue to one another. In an embodiment of the present invention the two tissues to be joined, for example the lower esophagus and the fundus of the stomach, are first placed adjacent to one another. Next a first restraint is placed near the outside surface of one of the tissues and a second restraint is placed near the outside surface of the other tissue. An irritant is then placed between the two adjacent tissues. The restraints, and consequently the tissue surfaces, are then drawn together. As the touching irritated tissue surfaces heal they will become bonded to one another and their need for the mechanical fastening of the restraints, to secure them together, will be diminished.

Abstract: A magnet delivery system for forming an anastomosis that comprises a wire guide; a catheter having a delivery portion for advancement into a jejunal space, the delivery portion having a lumen extending at least partially therethrough, a first port and a second port through which the wire guide is disposed; a magnet comprising a lumen therethrough wherein the magnet is removably secured to the delivery portion of the catheter between the first and second ports by disposing the wire guide through the lumen of the magnet, the first port, and the second port.

Abstract: Devices and methods for tissue acquisition and fixation, or gastroplasty, are described. Generally, the devices of the system may be advanced in a minimally invasive manner within a patient's body, e.g., transorally, endoscopically, percutaneously, etc., to create one or several divisions or plications within the hollow body organ. Such divisions or plications can form restrictive barriers within a organ, or can be placed to form a pouch, or gastric lumen, smaller than the remaining stomach volume to essentially act as the active stomach such as the pouch resulting from a surgical Roux-En-Y gastric bypass procedure. Moreover, the system is configured such that once acquisition of the tissue by the gastroplasty device is accomplished, any manipulation of the acquired tissue is unnecessary as the device is able to automatically configure the acquired tissue into a desired configuration.

Abstract: A medical treatment device includes an elongate member having an internal volume, a proximal end, and a distal end, the internal volume extending from the proximal end to the distal end. The medical treatment device further includes a first coupler and a second coupler, the first coupler and the second coupler coupled to the internal volume of the elongate member; a first joining member and a second joining member, the first joining member coupled to the first coupler and the second joining member coupled to the second coupler. The first joining member is configured to attach to a first biological matter location, and the second joining member is configured to attach to a second biological matter location, the second location being distal to the first location. The second coupler is configured for manipulation to align relative the first coupler such that the second biological matter location relocates adjacent the first biological matter location.

Abstract: Provided is a method of resecting a luminal structure, such as a colon. A first luminal structure and a second luminal structure are defined by severing the original luminal structure. The second luminal structure is secured to the distal end of an elongate body disposed within the second luminal structure. Refraction of the elongate body forms a circumferential fold in the second luminal structure and isolates a tissue mass between the circumferential fold and the distal end of the elongate body. The second luminal structure is then transected circumferentially at or adjacent the circumferential fold, thus severing the tissue mass. The tissue mass is then removed by retracting the distal end of the elongate body. The free end of the second luminal structure is approximated with the free end of the first luminal structure and secured by conventional surgical methods. Instrumentation for use with the inventive method is also provided.

Abstract: A magnamosis system for auto-anastomosing a region of the body using implants with magnetic members that may be individually delivered to different locations in the body. The implants with their magnetic members have a mating surface and polar alignment that generates an attractive force to compress tissue in the region between them. The tissue in the region necroses as a result of the compressive force such that tissue surrounding the necrosed tissue heals together to form an anastomosis.

Abstract: Apparatus for reconfiguring tissue, the apparatus comprising a shaft having a distal end and a proximal end; at least one effector mechanism movably mounted to the distal end of the shaft, each effector mechanism comprising at least one gripping element for gripping tissue to that effector mechanism, the at least one effector mechanism being configured to capture the gripped tissue against said shaft, at least one actuating mechanism mounted to the proximal end of the shaft, and at least one connection mechanism connecting the at least one actuating mechanism to the at least one effector mechanism, whereby a user may utilize the at least one actuating mechanism to actuate the at least one effector mechanism so as to reconfigure tissue.

Abstract: A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: An apparatus for regulating the functioning of a patient's organ or duct includes an elongated member having a first end and a second end. A fastener is disposed on the first end of the elongated member. The fastener is configured to engage the second end of the elongated member so that the elongated member forms a loop around the organ or duct. A tension element is disposed for movement within the elongated member. A symmetrical drive system including a drive element associated with and engaging the tension element for causing the tension element to control the tension applied by the elongated member against a patient's body organ or duct is further provided. In accordance with an alternate embodiment an apparatus for regulating the functioning of a patient's organ or duct including an elongated member having a first end and a second end. A fastener is disposed on the first end of the elongated member.

Abstract: An assembly for joining two vessel segments of a patient includes a coupler formed of adjoining coupler halves. Each coupler half includes an aperture for receiving an end of one of the vessel segments. One of the coupler halves includes a connector element configured for connection to the other coupler half. The vessel segments are alignable in the respective coupler halves such that a path for fluid flow is formed therebetween upon connection of the coupler halves. A probe is aligned in engagement with a coupler half for generating a signal corresponding to fluid flow through the path.

Abstract: Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Abstract: Disclosed are compositions, methods, and kits for joining together non-conjoined lumens in a patient's body including vascular lumens. More particularly, in various aspects, this invention provides compositions, methods, and kits for joining such non-conjoined lumens, including small lumens typically requiring microsurgical technique.

Abstract: Medical system and methods are provided for forming an Anastomosis, such as an intestinal bypass anastomosis for treatment of obesity or diabetes. The medical devices and methods are minimally invasive and reduce complications. One embodiment of the method includes forming a first opening in the first section and forming a second opening in the first section. A proximal portion of the second section is moved to a position adjacent the first opening, and a distal portion of the second section is moved to a position adjacent the second opening. In this manner, an intermediate portion of the second section extends along the first section and an anastomosis can then be formed between the first section and the second section.

Abstract: Provided is an anastomotic device including a first holder and a second holder for holding a first anastomotic ring and a second anastomotic ring, respectively, a first slave body which is connected to the first holder, and which has a first slave surface, a second slave body which is connected to the second holder, and which has a second slave surface, a first driving body which has a first driving surface sliding along the first slave surface, and which moves along a predetermined direction, and a second driving body which has a second driving surface sliding along the second slave surface, and which moves along the predetermined direction. The first slave body moves toward the second slave body and the second slave body moves toward the first slave body by the movements of the first driving body and the second driving body.

Abstract: A method for creating an anastomosis between a stomach and a portion of a small intestine, and simultaneously controlling passage of stomach contents through a pylorus with a pylorus plug that includes a valve operative to either close or at least partially open passageway through the pylorus.

Abstract: Disclosed is a conduit that provides a bypass around an occlusion or stenosis in a coronary artery. The conduit is a tube adapted to be positioned in the heart wall to provide a passage for blood to flow between a heart chamber and a coronary artery, at a site distal to the occlusion or stenosis. The conduit has a section of blood vessel attached to its interior lumen which preferably includes at least one naturally occurring one-way valve positioned therein. The valve prevents the backflow of blood from the coronary artery into the heart chamber.

Abstract: Apparatus for performing a surgical anastomosis include a tubular body having an onion portion formed near the distal end of the tubular body. The apparatus includes a sleeve having a radius sized and dimensioned to slidably receive the tubular body therein. The apparatus includes a plunger assembly sized and dimensioned to be slidably received within the central lumen of the tubular body. The plunger assembly includes a distal end configured and adapted to deploy the onion portion.

Abstract: An apparatus for performing endoluminal anastomosis of an organ comprises an operative head including an endoscope receiving lumen for slidably receiving a flexible endoscope therein, the operative head including an annular tissue receiving space extending around a circumference of a distal end thereof and a stapling mechanism for firing staples around an entire circumference of the tissue receiving space and a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ.

Abstract: An apparatus for forming an anastomosis between adjacent intestinal sections of tissue is provided. The apparatus includes a circular surgical stapler having an anvil assembly with an anvil shaft and an anvil, the circular surgical stapler further having a tubular body portion with an annular knife and a body portion shaft selectively attachable to the anvil shaft; and a seal structure for deposition between the intestinal sections of tissue including a hub configured to engage attachment structure on at least one of the anvil shaft and the body portion shaft. The attachment structure is positioned so that the seal structure is located between the intestinal sections of tissue when the circular surgical stapler is disposed within the intestinal sections of tissue.

Abstract: A tool for slitting an elongate sheath from about an elongate member that is disposed within a longitudinally extending lumen of the sheath includes a longitudinally extending tail portion projecting rearward of a slitting edge and a nose portion of the tool; a lower surface of the nose portion is disposed beneath the slitting edge for engaging a portion of the elongate member. The tail portion of the tool, approximately aligned with the sheath lumen when the lower surface, engages the elongate member and a leading edge of the nose portion is within the sheath lumen, is sized to fit within the sheath lumen after the sheath is slit by the slitting edge. A passageway between the nose portion and the tail portion allows a proximal segment of the elongate member to bend away from the tail portion when the elongate member is engaged by the nose portion.

Abstract: A device for assisting in a vascular procedure is provided that includes a handle and one or more legs that are operable to move in response to a force being applied to the handle. The legs are operable to extend and to contract in order to manipulate a conduit. In a more particular embodiment, the device can be used in conjunction with a stand operable to receive the conduit such that the conduit can be removed from the stand by the device. The stand may include one or more graduations that indicate the size of the conduit once it is positioned on the stand.

Abstract: The invention relates a sheath that is affixed to a body lumen, proximal to an anastomosis site. The sheath includes a sleeve defining a passage. A grasping structure is positioned distally of the distal opening of the sheath to facilitate elongation of the sleeve from a first length to a second longer length. A method for using the sheath is also disclosed.

Abstract: A device for anastomosis of a tubular structure comprises first and second hollow members having a rigid part and an elastic part, and a connection member for interlocking the first and second members. The elastic parts are essentially circular rings, and are made of a polymeric, a biocompatible and/or biodegradable material. The rigid parts have an outer surface that is partly semi-circular in cross section, wherein the diameter at a non-connecting end is larger than or equal to the diameter at a connecting end, which ends in an edge. The first and second members are connected to each other so that a distance is formed between the elastic parts. A cavity is formed between the rigid parts and the connection member and the tubular structure, when arranged in the device.

Abstract: Surgical tissue fasteners and related deployment systems and methods are disclosed. A tissue fastener used to join multiple tissue layers includes a first member, a second member, and a connecting member connecting the first and second members. In some embodiments, the first and second members are configured to expand from a delivered state to a deployed state in which the fastener secures the tissue layers together. In other tissue fastener embodiments the connecting member has an elastic compressive spring force for applying a substantially constant force on the tissue layers for adjusting a length of the connecting member between the first and second members.

Abstract: According to an aspect of the present disclosure, an apparatus for forming an anastomosis between adjacent sections of tissue is provided. The apparatus includes a body portion; an actuation assembly operatively supported at a proximal end of the body portion; an anvil assembly movably mounted at the distal end of the body portion for movement toward and away from the body portion; an approximation assembly extending between the body portion and the anvil assembly for moving the anvil toward and away from the tubular body portion; a dispersion assembly operatively associated with the approximation assembly, the dispersion assembly including at least one angled surface defining at least one channel interposed between the anvil assembly and the body portion and being configured to dispense a fluid therefrom; and at least one conduit for conducting wound treatment material to the dispersion assembly.

Abstract: Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Abstract: A medical device is disclosed for joining a first tubular organ (1), such as a blood vessel, to a second tubular organ (2), such as a blood vessel. The kit includes an external tubular scaffold (4) with a removable scaffold handle (7,18,19) and a clip (3). In use, the clip (3) and the external tubular scaffold (4) remain outside of the tubular organs (1,2) being joined. The clip (3) embraces a first longitudinal tubular section (6) of the external tubular scaffold (4) thereby holding together a longitudinal segment of an intima of the first tubular organ (1) and a longitudinal segment of an intima of the second tubular organ (2).

Abstract: An integrated anastomosis tool may include an effector that both makes an opening in the wall of a target vessel and connects a graft vessel to the target vessel. The effector may include a cutter assembly and a connection module that are independently actuatable. The connection between the graft vessel and the target vessel may be compliant, and may be achieved by suturing an end of the graft vessel to the side of the target vessel with the connection module.

Abstract: The invention provides a device, assembly, and method for transoral endoscopic restoration of a gastroesophageal flap valve. The invention also provides a self-steering and self-closing tissue fixation device for tissue fixation, and an invaginator device for gripping and maneuvering tissue. The restoration device includes a longitudinal member arranged for transoral placement into a stomach, a tissue shaper carried on the longitudinal member that causes stomach tissue to assume a shape related to a gastroesophageal flap, and a tissue fixation device that maintains the shaped stomach tissue in a shape approximating a gastroesophageal flap. The tissue shaper may include a mold. The device may include the invaginator device for gripping and maneuvering esophageal tissue to aid restoration of the gastroesophageal flap, and may include the tissue fixation device.

Abstract: Disclosed are compositions, methods, and kits for joining together non-conjoined lumens in a patient's body including vascular lumens. More particularly, in various aspects, this invention provides compositions, methods, and kits for joining such non-conjoined lumens, including small lumens typically requiring microsurgical technique.