Abstract: An apparatus for the transoral invagination and fundoplication of the stomach to the esophagus includes a clip applier having sharp toothed jaws for grasping and damaging the fundus prior to applying the clip. The clip applier has an overall diameter of less than 7 mm. The clip applier jaws are coupled to a pull wire via a linkage which increases the mechanical advantage and thus permits greater grasping force. A plurality of clip designs are also provided.

Abstract: The invention consists of a hand gripping portion 11, a tissue manipulating portion 13 and a needle retaining means 16. The needle retaining means is placed proximal or adjacent to the tissue manipulating portion. It comprises a needle impervious sleeve 15, which contains a needle pervious material 18.

Abstract: A surgical instrument that automatically ties simple interrupted sutures is described. The user adjusts the tension in the suture loop. The instrument can use any of the currently used suture materials. In one form, sutures, a needle and two small blades come in a modular unit that is attached to a main piece. The advantages of conventional suturing are combined with the practicality of a surgical stapler.

Abstract: Intra-gastric fastening devices are disclosed herein. Expandable devices that are inserted into the stomach of the patient are maintained within by anchoring or otherwise fixing the expandable devices to the stomach walls. Such expandable devices, like inflatable balloons, have tethering regions for attachment to the one or more fasteners which can be configured to extend at least partially through one or several folds of the patient's stomach wall. The fasteners are thus affixed to the stomach walls by deploying the fasteners and manipulating the tissue walls entirely from the inside of the organ. Such fasteners can be formed in a variety of configurations, e.g., helical, elongate, ring, clamp, and they can be configured to be non-piercing. Alternatively, sutures can be used to wrap around or through a tissue fold for tethering the expandable devices. Non-piercing biased clamps can also be used to tether the device within the stomach.

Abstract: A system for implanting an implant and method thereof is disclosed. In general overview, the system includes an implant, an envelope enclosing the implant, a delivery assembly and an attachment piece for attaching the envelope or implant to the delivery assembly. The envelope may include a drug coating, positioning aids, and means to ease envelope removal. In one embodiment, the delivery assembly is employed for implant and/or envelope delivery inside the patient's body. In another embodiment, the delivery assembly and an attachment piece are employed to deliver the implant or the envelope inside the patient's body.

Abstract: Specifically, the anastomosis device of the present invention provides an anastomosis ring; such as but not limited to a ring of staples, in the form of an oval or ellipse. One specific embodiment of the present invention is a side to end anastomotic stapler with a row of staples formed in an elliptical pattern. Another embodiment of the present invention is a pair of anastomotic compression rings formed in an ellipse. A further embodiment of the invention is compression disc, rather than open ring structure.

Abstract: An implantable medical device, such as a stent, having roughened areas on an inner surface of the device for enhancing frictional contact between the medical device and a delivery system, such as a balloon catheter to secure the medical device to the delivery system during delivery of the medical device to a body lumen of a patient. Various methods for forming the roughened areas are also provided. The roughened areas may be coated with a material, such as a non-thrombogenic material, to enhance the compatibility of the inner surface of the medical device with fluid flowing through the vessel lumen of the patient.

Abstract: A surgical fastener for use in surgical procedures comprises a first member, a second member, and an anchor. Surgical materials may be secured within the surgical fastener. Methods of securing the surgical fastener to an anatomical structure are disclosed herein.

Abstract: Consistent with the present invention, tissue adhesive compositions and an associated laser exposure system are provided for bonding or sealing biological tissues. The compositions are comprised of chemically derivatized soluble collagen which is formulated to concentrations ranging from 300 mg/ml (30%) to 800 mg/ml (80%) collagen protein. In particular, Type I collagen, for example, is first prepared by extraction from bovine or porcine hide and purified. The collagen preparations are then chemically derivatized with sulfhydryl reagents to improve cohesive strength and with secondary derivatizing agents, such as carboxyl groups, to improve the adhesive strength of the solder to the tissue. The compositions are then formed into viscous solutions, gels or solid films, which when exposed to energy generated from an infrared laser, for example, undergo thermally induced phase transitions.

Abstract: This is a device for bridging the neck of either a wide-necked or narrow-necked aneurysm in the vasculature. In general, it is a device used to stabilize the presence of vaso-occlusive devices (such as helically wound coils) in the aneurysm. The device preferably is delivered by a core wire which terminates in an electrolytically severable joint. The core wire will often be insulated. The retainer assembly itself is also attached to the electrolytic joint and typically has a number of array elements which are intended to be resident within the aneurysm after the device is deployed from the distal end of a catheter. After deployment of this retainer, the aneurysm is at least partially filled with a vaso-occlusive device such as helically wound coils.

Abstract: The present invention relates to a three-needle type vascular closure system. The closure system utilizes three needles in the form of a guiding device, an expandable needle, and a hooking device. The guiding device is used to make the initial opening in the vessel, where the opening provides access for a sheath through which a medical procedure is to be performed. The expandable needle is inserted into the vessel in which it expands radially from the needle to form a target. The hooking device is also inserted into the vessel and is used to hook the expandable needle so as to form an internal union between the hooking device and the expandable needle. The needles can then be retracted thereby extending a suture from the hooking device and forming an internal suture pass that can be used to approximate the tissue surrounding the initial opening in the vessel. In one embodiment, the suture is passed across the vessel opening prior to dilation of the vessel opening.

Abstract: Apparatus and methods are disclosed for performing beating heart surgery. Apparatus is disclosed comprising a cannula having a proximal end and a distal end; an aortic filter in connection with the cannula, the aortic filter having a proximal side and a distal side; a check valve in connection with the cannula, the check valve disposed on the distal side of the aortic filter; and a coronary artery filter in connection with the cannula, the coronary artery filter having a proximal end and a distal end, and the distal end of the coronary artery filter extending distally away from the distal end of the cannula. A method is disclosed comprising providing apparatus for performing beating heart surgery; deploying the apparatus in an aorta; performing a procedure on the aortic valve; and removing the apparatus from the aorta.

Abstract: The present invention relates to devices and methods for creating and securing a tissue fold during an endoluminal medical procedure. The devices and methods may be used for folding and securing, for example, a fundus wall onto an esophagus wall. An aspect of the invention includes a two-piece tissue clip configured to be installed through an endoluminal device to secure a tissue fold. The clip includes a female member and a male member configured to engage one another to secure the tissue fold. Another aspect of the invention includes a clipping device comprising a tissue clip magazine. The magazine is configured to hold a plurality of tissue clips and install the plurality of tissue clips in a single actuation of the magazine. A method for using the clipping device together with the tissue clips of the present invention to create and secure a fold of tissue during an endoluminal procedure also is disclosed.

Abstract: A surgical blade is disclosed for use with a surgical tool for making incisions in the sclera of an eye to form a scleral pocket to receive a scleral prosthesis. The surgical blade comprises a rotatable support arm capable of being rotated by the surgical tool and a detachable curved cutting blade for making incisions in the sclera of an eye. The surgical tool causes the curved cutting blade to advance through the sclera to form an incision having dimensions to receive a scleral prosthesis. When the incision is complete the curved cutting blade is detached from the rotatable support arm. The curved cutting blade is then removed from the incision by pulling the curved cutting blade forward out of the incision. The incision has the exact dimensions to receive a scleral prosthesis.

Abstract: A jig assembly includes a jig having an elevated first portion having holes or slots to align a drill with screw holes in an intramedullary portion of a fixation device, and a lower second portion having openings in axial alignment with holes on a plate portion of the fixation device. The jig may be locked relative to the fixation device. The jig assembly further includes one or more of sleeves, drill guides and gauges for facilitating the drilling of appropriate holes into bone both beneath and above the fixation device.

Abstract: A cutting instrument configured as scissors has a housing formed as a handle with a functional unit disposed therein; supported in the functional unit is a probe configured as a hollow needle which co-axially supports a rod projecting from the probe in axial direction and which comprises at its distal end a cutting device and wherein the cutting device has two cutting members provided with cutting blades that can be configured in an arc-shape or a straight shape, wherein from an open position the cutting blades correspond to each other at an acute angle, they are brought into engagement with each other to a closed position for a cutting action by means of a sliding movement of the probe relative to the scissors tip.

Abstract: A tool for performing anastomosis connects two tissue structures end-to-end. An end of each of the two tissue structures is sized to a known interface dimension with a tissue preparation device, and two or more cuts are made in that end to create at least two flaps. a clamp holds each tissue structure, and each clamp may be integrated with a tissue preparation device. The clamps are movable relative to one another, and are registered together such that the flaps of one tissue structure are pressed against the corresponding flaps of the other tissue structure when the clamps come together. Each flap of one tissue structure is connected to a corresponding flap on the other corresponding tissue structure with at least one connector such as a staple or other fastener.

Abstract: A tourniquet system having a strap, a clamp for selectively engaging the strap in which once the clamp engages the strap, the clamp permits the strap to pass substantially freely in a direction away from the clamp and substantially prevents the strap from passing in a direction towards the clamp and securing structure attached to the strap for securing the strap.

Abstract: An anastomosis is performed using a flexible mounting structure mounted on the outside of at least one vessel. Fasteners extend through the vessel and are bent towards the incision to attach the flexible mounting structure to the vessel in a manner that controls the edge of the vessel adjacent to the incision. The mounting structures are oriented on each vessel so fasteners on one mounting structure interdigitate with fasteners on the other mounting structure at the location of contact between the vessels when the two vessels are brought together. This creates two complementary sinusoidal-shaped vessel edges with peaks of one edge being accommodated in the valleys of the other edge. The peak-to-valley orientation forms a sinusoidal-shaped joint which is leak free. The fasteners are spaced so proper pressure is applied to the tissue to promote healing without leaking. Furthermore, the fasteners are sized and shaped to properly engage the tissue and bend in a desired manner.

Abstract: The present invention relates to a forceps used for the surgical reduction of facial bones, characterized by the fact that it comprises two shaped branches diverging from opposite sides starting from a central elastic loop. Each branch develops on three Cartesian axis and has a first rectilinear section joined to a second section with 90° orientation, laying on the same plane that contains the loop and joined in turn with a 90° ending section, whose end is slightly bent towards the central loop.