Abstract: An arterio-venous graft (16) is provided with a constriction device (20) near its arterial end. The constriction device (20) is used to reduce the flow through the AV graft under normal conditions and to relieve the constriction when high flow through the AV graft is required, such as for vascular access for hemodialysis.

Abstract: The present invention generally provides a gastric banding system, including an implantable access port. The access port assembly may comprise a self-sealing septum, a housing, a mesh rivet and a mesh layer. The housing may include a septum retaining portion for holding the septum in place, and a base for defining an internal fluid reservoir and further defining a rivet receiving portion and a rivet engaging member, the housing further including a tubing connector configured to connect to a tubing for the movement of fluid into and out of the internal fluid reservoir. The mesh layer may be positioned beneath the housing and may define a plurality of spaces. The mesh rivet may engage the rivet engaging member to hold the mesh rivet in place while holding the mesh layer between a base of the mesh rivet and the housing of the access port.

Abstract: A power management system provides wireless power to operate components of a remotely adjustable gastric banding system. The power management system comprises an external power component transmitting power, and an implantable power management component receiving power and converting the power for use in powering one or more components of the remotely adjustable gastric banding system, such as a pump. The internal power management component and the external power component may be tunable. By utilizing the power management system, implantable batteries may be eliminated.

Abstract: A mechanism for removing a fluid-filled object such as an intragastric balloon from a patient. The apparatus includes a delivery tube having a lumen and a retrieval tool able to slide within the lumen that can both puncture and grasp the intragastric balloon. The retrieval tool may have sharpened graspers with either a sharp tip and/or knife-like edges. Alternatively, the delivery tube itself may have sharpened cutting blades that deploy outward to puncture the intragastric balloon. One embodiment utilizes a suction cup tip on the delivery sheath and a sharpened puncture rod that extends past the distal tip of the lumen, for rapid deflation of a balloon. Various embodiments hasten the deflation process and simplify the manipulation required by the surgeon.

Abstract: The present invention includes a source reservoir with potential energy for a system for facilitating obesity control. The system includes a remote transmitter, a gastric band including at least one inflatable portion for containing a fluid, at least one reservoir for containing the fluid, and a high precision pump unit in communication with the reservoir for controlling pressure within the inflatable portion.

Abstract: A mechanism for removing a fluid-filled object from a patient. The apparatus includes a deflation tube with a puncture member at one end of the tube for piercing a hole in the object wall. The apparatus includes a retrieval mechanism slidable within the deflation tube lumen. The retrieval mechanism includes an expansion element that is expandable when positioned within the object from a first configuration with a dimension less than that of the deflation tube lumen to a second or deployed configuration with a dimension that is greater than an outer dimension of the puncture member. The expansion element contacts an inner surface of the inflatable object as the deflation tube and retrieval mechanism are withdrawn from the body cavity. The expansion element may be a T-bar, a foldable anchor, an inflatable member, or another expandable form.

Abstract: Generally described herein are devices, methods and systems related to detecting a leak present in a gastric banding system for the treatment of obesity. For example, a leak detector may include a syringe, a leak sensing unit and a needle, and may measure a pressure decay within a gastric banding system after the needle penetrates the patient's skin and is inserted into an access port connected to the gastric band of the gastric banding system. The pressure decay may be interpreted to determine if a leak is present in the gastric banding system.

Abstract: The present invention provides a system for attaching a fluid access port to a patient. The system generally comprises an implantable access port with a bottom exit port and method for attaching an access port to a patient. In addition, a tube guard, flexible tube exit port, tissue guard, and porous coupling member are disclosed.

Abstract: The present invention provides a system for attaching a fluid access port to a patient. The system generally comprises an implantable access port and method for attaching an access port to a patient. In addition, a tube guard, tube shroud, tissue guard, porous coupling member and a prefabricated mesh member may be attached to the access port. For example, the prefabricated mesh may be coupled to the access port to facilitate securing the access port to the tissue of the patient.

Abstract: The present invention generally relates to medical systems and apparatus and uses thereof for treating obesity and/or obesity-related diseases, and more specifically, relates to systems and methods for energy recovery in a laparoscopically-placed gastric banding system operably coupled to a piezo actuator. The energy recovery may be obtained utilizing an energy recovery device, such as an inductor, coupled to the piezo actuator. The energy recovery device may utilize two circuits to facilitate energy recovery, and the two circuits may include diodes with opposite orientations to control current flow.

Abstract: An implantable device comprises a reservoir that contains a fluid for filling an inflatable portion of a gastric band. A device is coupled to the reservoir and includes stored potential energy having a first state and a second state. The first state represents a higher level of potential energy and the second state represents a lower level of potential energy. The implantable device further comprises a filling valve coupled between the reservoir and the gastric band, and the filling valve is configured to be opened in response to a first telemetric signal. The stored potential energy decreases from the first state to the second state when the filling valve is open, and a filling amount of the fluid moves from the reservoir to the gastric band when the stored potential energy decreases from the first state to the second state.

Abstract: A needle capture device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, a housing at the distal ends of the shaft and tubular member, and a capture mechanism situated within housing. The housing has an alternating arrangement of flights and spaces radially arrayed about its exterior dimensioned to be closely received within an endoscopic instrument channel so as to coaxially orient said housing with the instrument channel. The capture mechanism has a first configuration in which it is adapted to receive and retain a needle presented into the distal end of the instrument channel, and a second configuration in which it is adapted to release the needle from the instrument channel.

Abstract: A two-part suture cinch includes a collar and a plug. A cinch applicator is also provided, and includes an elongate tubular member, a plunger engaged within the distal end of the tubular member, a flexible shaft extending through the tubular member and plunger, and a proximal handle for moving the shaft longitudinally relative to the tubular member. The plunger includes a distal housing for the collar of the cinch, and the plug is coupled to the distal end of the flexible shaft. The suture is thread through the collar and a portion of the applicator. Operation of the applicator draws the plug into the collar and clamps the suture between the plug and collar. In addition, once the plug is coupled in to the collar, the plunger is displaced proximally to release the two-part cinch form the applicator. A method for applying the cinch is also provided.

Abstract: An access system includes a proximal handle, an overtube coupled to the handle, and an endoscope port extending through handle and overtube sized for receiving an endoscope therethrough. The overtube includes anatomic wall securing system that secures a distal portion of the overtube within a hole in the anatomic wall. The overtube is provided with a shaped distal portion or a controllably shapeable distal portion that aids in directing an endoscope inserted through the port to a particular location within the peritoneal cavity. The access system includes a system for insufflating/deflating the peritoneal space separately from the body cavity accessible via a natural orifice. The access system includes a closure system to cinch closed the hole made in the anatomical wall after the access system has been removed from the hole. Methods are provided for inserting the access system through the anatomical wall to perform intra-abdominal surgery.

Abstract: A two-part suture cinch includes a collar and a plug. A cinch applicator is also provided, and includes an elongate tubular member, a plunger engaged within the distal end of the tubular member, a flexible shaft extending through the tubular member and plunger, and a proximal handle for moving the shaft longitudinally relative to the tubular member. The plunger includes a distal housing for the collar of the cinch, and the plug is coupled to the distal end of the flexible shaft. The suture is thread through the collar and a portion of the applicator. Operation of the applicator draws the plug into the collar and clamps the suture between the plug and collar. In addition, once the plug is coupled in to the collar, the plunger is displaced proximally to release the two-part cinch form the applicator. A method for applying the cinch is also provided.

Abstract: Instruments, systems, implants, and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, and a mucosal resection device. A submucosal implant device for diagnosing and treating disorders of the body may be implanted. A passive submucosal implant device may take the form of a drug delivery depot in which a therapeutic agent within the depot elutes from the depot according to a predetermined elution profile. An active submucosal implant device may take the form of a drug delivery device that incorporates a self-contained diagnostic system to determine the appropriate delivery time and dosage of a therapeutic agent to be administered.

Abstract: A medical apparatus including: a projecting member; an introducing sheath; an extrusion member inside the introducing sheath, at a proximal side of the projecting member and movable in an axial direction with respect to the introducing sheath; a cover sheath outside the introducing sheath, the introducing sheath being movable between a first and second position with respect to the cover sheath; an introducing sheath manipulating section at a proximal side of the introducing sheath; an extrusion member manipulating section at a proximal side of the extrusion member; a cover sheath manipulating section at a proximal side of the cover sheath; and a release member on the cover sheath manipulating section and/or the introducing sheath manipulating section to release a fixation between the extrusion member manipulating section and the introducing sheath manipulating section when the introducing sheath is disposed on the first or second position.

Abstract: A method for forming an artificial valve includes inserting a sheath having proximal and distal sections and a lumen extending therethrough orally into a body cavity; inserting an endoscope orally into a body cavity, the endoscope being slidably positioned within the sheath; holding tissue in a vicinity of a junction of a stomach and an esophagus where the artificial valve is to be formed, using a holding device extending from the sheath; penetrating through tissue of the esophagus and then through tissue of the stomach at an oral side of the junction of the stomach and the esophagus with a needle provided outside of the endoscope which is not mechanically connected to the holding device and which is moveable outside of the endoscope relative to the endoscope; and passing a binding member through the tissue of the esophagus and the tissue of the stomach using the needle.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A transluminal approach through a natural body cavity to repair a ventral hernia is provided. In a transgastric approach, the abdominal cavity is accessed via an incision through a wall of the digestive tract. A system for the deployment of tissue anchors to anchor a tissue reinforcing mesh to repair the ventral hernia is provided. Particular tissue anchors are disclosed. In certain embodiments, the tissue anchors include a shaft and a head reconfigurably coupled to the shaft permitting the head and shaft to be in a substantially parallel loaded configuration and in a substantially transverse deployed configuration. In addition, tissue anchors may include biodegradable and non-biodegradable components, with the non-biodegradable component defining spaces for soft tissue ingrowth upon degradation of the biodegradable component.