Abstract: A minimally invasive surgical suturing device has a shaft; a needle slideably coupled to the shaft and having a ferrule engaging end; and a guide tip having a ferrule receiving aperture and moveably coupled to the shaft for selectable movement between a retracted position and an enabled position. In a related method, a distal shaft end, having a guide tip in a retracted position, is passed through a minimally invasive entry point and into a body cavity. The guide tip having a ferrule receiving aperture is actuated into an enabled position such that an insertion profile of the guide tip and shaft in the enabled position is larger than an access dimension of the minimally invasive entry point. A needle, slideably coupled to the shaft and having a ferrule engaging end, is advanced on a path substantially parallel to the shaft, toward and in alignment with the ferrule receiving aperture.

Abstract: A uterine manipulator includes a sound and a body. The sound has a selectively actuatable anchor disposed proximate a distal end and an operating mechanism spaced from the anchor for controlling actuation of the anchor. The body has a passage therethrough adapted to receive the sound passed proximally through the body to a position in which the operating mechanism is accessible proximally of the body and the anchor extends distally.

Abstract: A device for placing sutures through thick and/or moving tissue such as the wall of a beating heart. The device includes a tissue welting tip having a trough for forming a welt in a tissue section, an alignment guide having an opening receiving a guide wire and pivotally mounted in the distal end adjacent to the trough, and an elongated sleeve slidably engagable with the guide wire. The device also includes one or more expandable tissue engaging member(s) on the sleeve expandable from a collapsed configuration having a diameter small enough to pass through the opening in the tip to an expanded configuration having a diameter large enough to engage a tissue section and urge it into the trough to form a welt in the tissue section and a retractable needle extendable through at least two portions of a tissue section while the tissue section is engaged with the trough.

Abstract: An anatomic vaginal occluder is constructed of soft, relatively compliant materials for atraumatic insertion through the vaginal opening. This device integrates at its distal end a horizontally oriented, elliptically shaped, occlusive prominence coupled with a larger vertically oriented, elliptical occlusive prominence, located more proximally on the device's longitudinal axis. The vaginal wall tissue is compressed radially and put under longitudinal tension completely circumferentially around the occlusive features to create a seal against gas loss.

Abstract: A surgical pledget assembly includes a pledget body having first and second apertures extending through the body, one or more snares passing through the apertures in the pledget body and including first and second suture engaging loops disposed on a distal side of the pledget, an optional third folding loop disposed on a proximal side of the pledget, and a handle secured to the ends of the snare or snares proximal to the pledget.

Abstract: A method and apparatus for closing a punctured blood vessel is described. The apparatus includes a suturing instrument adapted to apply at least one suture to at least a portion of a blood vessel in order to close a puncture wound therein. In a preferred embodiment, the suture is secured by crimping a sleeve member over the free ends of the suture with a crimping instrument.

Abstract: A uterine manipulator includes a sound and a body. The sound has a selectively actuatable anchor disposed proximate a distal end and an operating mechanism spaced from the anchor for controlling actuation of the anchor. The body has a passage therethrough adapted to receive the sound passed proximally through the body to a position in which the operating mechanism is accessible proximally of the body and the anchor extends distally.

Abstract: A surgical suturing instrument has a needle which traverses at tissue receiving gap and picks up suture distal to the gap. This invention provides an automated mechanism enabling the suture to be removed from the needle after the needle is retracted proximal to the tissue gap. This mechanism provides enhanced device reloading and other potential uses.

Abstract: A crimpable magnesium sleeve for securing a suture within the body and for dissolving over time while introducing only compatible amounts of magnesium into the body. An instrument for placing such a sleeve on a suture crimping the sleeve and cutting the suture after placement. An alloy of magnesium, zinc, and aluminum may be used to form the sleeve.

Abstract: A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to flex relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. Tissue suturing and suture securing instruments are provided each having a sufficiently flexible shaft locatable through the accessory tube.

Abstract: A surgical pledget assembly includes a pledget body having first and second apertures extending through the body, one or more snares passing through the apertures in the pledget body and including first and second suture engaging loops disposed on a distal side of the pledget, an optional third folding loop disposed on a proximal side of the pledget, and a handle secured to the ends of the snare or snares proximal to the pledget.

Abstract: Abstract An instrument for cutting tissue to controlled dimensions for removal of tissue specimens from remote sites in the body of a patient. The instrument has a housing and a substantially flexible shaft extending from the housing to a distal end. Suction can be municated along the shaft to the distal end for distribution across a cavity utilizing a nifold to pull tissue into the cavity against a tissue engaging of the manifold. One or more needles are extendable into the cavity to enable infusion of fluid into the tissue. A blade in the distal end is extendable over the manifold to cui the tissue held by suction in the cavity. The shape and depth of the tissue removed by the cut is in accordance with the contour of the tissue engaging surface and the size and shape of the cavity at the distal end.

Abstract: A device for placing one or more sutures through a section of tissue, especially a section of thick and/or moving tissue such as the wall of a beating heart. The device includes a tissue welting tip having a trough for forming a welt in a tissue section, an alignment guide pivotally mounted in the distal end adjacent to the trough, and having an opening receiving a guide wire and an elongated sleeve slidably engagable with the guide wire there through. The device also includes one or more expandable tissue engaging member(s) on the sleeve selectively expandable from a collapsed configuration having a diameter small enough to pass through the opening in the tip to an expanded configuration having a diameter large enough to engage a tissue section and urge it into the trough to form a welt in the tissue section and a retractable needle extendable through at least two portions of a tissue section while the tissue section is engaged with the trough.

Abstract: An instrument is provided for cutting tissue having a housing, a shaft extending from the housing to a distal end with an opening, and a guide tube extending from the distal end through the opening for receiving a guide wire through the shaft and housing. A movable blade shuttle having a blade is provided at the distal end. The blade shuttle's travel is guided by the guide tube when the blade shuttle and blade is extended from the distal end opening to cut tissue and retracted back through the distal end opening. The housing has a pivotal actuator member mechanically coupled to the blade shuttle to remotely control movement of the blade shuttle at the instrument's distal end. The instrument may be used for longitudinal cutting of tissue at remote sites in the body of a patient to provide incisions of precise depth and length over a controlled path of a guide wire.

Abstract: An instrument is provided having a shaft extending to a distal end having a cavity, and a passageway extending to the cavity through which a first suture end of a suture loop extends from a tissue site to facilitate a user looping a second suture end around the first suture end between the tip and the site to form a knot. Advancing of the distal tip while drawing the first suture end through the passageway pushes the knot to the site. The distal tip of another embodiment adds another passageway through which the second suture end is passed to assist in forming and pushing a knot at to the tissue site. The distal end has two openings through which two suture ends are passed from the placed knot, and a blade in the distal end is positionable to cut the suture ends near the knot.

Abstract: A therapeutic instrument for the ergonomic, effective and safe opening and closing of targeted remote tissue sites; includes a pistol grip style handle with a hand activated lever for needle deployment and, optionally, with features to control tissue cutting and guide wire installation; also incorporates a specialized elongated rigid or flexible instrument shaft, which enables vacuum assisted holding of tissue at a uniquely contoured distal tip, where placement of a suture in a purse string configures occurs along with, if desired, tissue cutting and guide wire passage.

Abstract: A therapeutic instrument for the ergonomic, effective and safe opening and closing of targeted remote tissue sites; includes a pistol grip style handle with a hand activated lever for needle deployment and, optionally, with features to control tissue cutting and guide wire installation; also incorporates a specialized elongated rigid or flexible instrument shaft, which enables vacuum assisted holding of tissue at a uniquely contoured distal tip, where placement of a suture in a purse string configures occurs along with, if desired, tissue cutting and guide wire passage.

Abstract: A therapeutic instrument for the ergonomic, effective and safe opening and closing of targeted remote tissue sites; includes a pistol grip style handle with a hand activated lever for needle deployment and, optionally, with features to control tissue cutting and guide wire installation; also incorporates a specialized elongated rigid or flexible instrument shaft, which enables vacuum assisted holding of tissue at a uniquely contoured distal tip, where placement of a suture in a purse string configures occurs along with, if desired, tissue cutting and guide wire passage.

Abstract: Color-difference signals that become unnecessary after rotation are deleted from a second pixel while saving color-difference signals that become necessary after rotation in the second pixel, to thereby form image data conforming to YUV422 format. The image data is then rotated, and subsequently the color-difference signals saved in the second pixel are returned to the original first pixel, to thereby form image data conforming to YUV422 format.