Abstract: Adjustable length element includes a first member having threads and a second member having threads. The adjustable length member also includes at least one protrusion on one of the first member and the second member, with the at least one protrusion being capable of engaging and disengaging at least one stop associated with the threads of the other of the first member and the second member as the first member and the second member are rotated relative to each other. A lancet device includes a housing, a needle holding member in the housing for holding a lancet, a biasing element for biasing the needle holding member toward an extended position, and a trigger for releasing the needle holding member from a retracted position. The lancet device also includes a cap for covering the housing and for positioning the lancet device relative to a skin surface, the cap including a first cap member having threads and a second cap member having threads.

Abstract: A graft with a stent, includes: a stent composed of a resilient wire having a supporting frame comprising a wire having a zigzag shape forming top and bottom portions; and tubes being made of plain woven of polyester resin fibers and having a thickness of 20 &mgr;m to 100 &mgr;m. The tubes are disposed between inner surface and outer surface of the stent, and the inner tube surface and the outer tube surface are partially adhered to each other by a polyester resin. The graft is free from hindrance of blood from flowing by kink and/or arctation in a corner such as an arched portion, a curved portion, and meandering portion, is resistant to expansion and contraction and bending, and is fit to a shape of a blood vessel of a human body. The graft is usable for a total percutaneous intravascular surgery because it can be inserted into a sheath having a small diameter because of a thin artificial blood vessel, and is prone not to have leakage from a connection with a blood vessel.

Abstract: A thin-walled prosthesis is provided that includes a tubular graft formed of a monofilament fiber. The graft has sufficient strength and durability to withstand loads applied during deployment and while implanted and sufficiently low permeability to prevent excessive leakage of body fluids through the material or to provide a sufficient seal, for example, so as to prevent aneurysm pressurization. A preferred embodiment of the present invention relates to a tubular grafts constructed of monofilament fibers for endoluminal placement within a body lumens, including blood vessels, and for the treatment of abdominal and other aneurysms.

Abstract: A thrombus filter which can be securely fixed in a selected location in the vascular system of a patient and removed when no longer required. The thrombus filter includes a plurality of struts which radiate from a body portion to form the generally conical shape of the thrombus filter. The thrombus filter includes anchor members joined to the free end of each strut. The thrombus filter includes an insulating layer substantially covering the thrombus filter including the body portion, the struts and the anchor members. The insulating layer includes an opening proximate the anchor members. The opening in the insulating layer creates a conductive path between the thrombus filter and the patient's body. When removal of the thrombus filter is desired, a first electrical conductor forms an electrical connection with the body portion of the thrombus filter. A second electrical conductor forms an electrical connection with the patient's body.

Abstract: An external fixator system comprises a clamp adapted to couple a fixator pin to a connecting rod. The clamp includes a slot for transversely receiving the connecting rod. A bolt is inserted through a bore passing transversely to the slot to engage a pin connector holding a fixator pin. The pin connector has a rod-engaging surface that wedges the connecting rod into the slot thus increasing the clamp's rigidity by preventing rotation of the clamp around the rod and rotation of the pin connector in the clamp body. An aiming device is also disclosed, which attaches to at least two connecting rods to guide the insertion of fixator pins between the rods. The aiming device is adjustable to accommodate various distances between the rods and has different modes of attachment to the rods to enable the clamp installation either above or below the rods.

Abstract: A biodegradable stent for implantation into a lumen in a human body. The stent in one embodiment is made from a biodegradable fiber having an inner core and an outer layer. The outer layer is a blend of two polymer components. The inner core has a first degradation rate, and the outer layer has a second degradation rate. The second degradation rate is slower than the first degradation rate. The fiber softens in vivo such that the stent is readily passed from the lumen as a softened fragment or filament after a predetermined period of time through normal flow of body fluids passing through the lumen.

Abstract: Medical devices, such as drainage stents, having coiled structures are useful in draining body fluids. A medical device has a first elongated section with a first cross-sectional area and a second elongated section with a second cross-sectional area. The second elongated section extends from the first elongated section. The second cross-sectional area is smaller than the first cross-sectional area. The second elongated section is or has at least one coiled structure with a plurality of turns, such as a helical coil tail.

Abstract: An ablation burr has a body provided with an inner circumferential rim and an outer circumferential rim that are concentric and spaced longitudinally by a selected distance along the length of the burr. The outer circumferential rim has a generally smooth convex outer surface that reduces damage to a vessel wall or stent A leading surface of the burr extends between the inner and outer circumferential rims in a substantially uniform, concave manner. An abrasive, for example, diamond grit, is provided on the leading surface. The burr is selectively rotated by a drive shaft, causing the abrasive leading surface of the burr to ablate unwanted deposits. If desired, a wire extends co-axially through the body such that a distal end of the wire extends out of the distal end of the burr. An abrasive tip may be coupled to the distal end of the wire, and is selectively rotated, to ablate unwanted deposits.

Abstract: A device for dilating nasal passageway which includes a resilient bar having pads on opposite ends for insertion into respective nasal passageways and the bar when bent causes a biasing outward force on the pads to dilate the anterior section of the nasal cavity with said bar having notches thereon which can be selectively cut to reduce the bearing force on the pads.

Abstract: An improved screw and apparatus for placing screws in a wire mesh and/or bone plate during an operation. In the preferred embodiment, the screw is self-tapping and the apparatus includes color-coded screw cartridges that mount directly onto the tip of a screwdriver and are held in place until installed in the proper location as dictated by the surgeon. The cartridge fits into a magazine that can feed the screw cartridges automatically into a screw gun that drives the screw into the proper location in the bone and the wire mesh or plate, or alternatively can be used with a manual screwdriver.

Abstract: Filter systems and a method of deploying a medical filter within a channel in a patient's body, the filter systems include a filter having a radially expandable body with an opening in a proximal length thereof. The filter is urged along a length of the channel with the filter body in a radially reduced configuration. The filter body is expanded to substantially fill the lumen of the vessel and orient the opening in the body proximally. Body fluid is permitted to enter the filter body through the proximally oriented opening and pass distally through the distal length of the body so that the distal length of the body filters from the body fluid particulate material entrained therein. The proximal length of the body can be drawn into the retrieval catheter, thereby effectively closing the proximally oriented opening within the catheter to retain the particulate material within the enclosure.

Abstract: An apparatus and method for forming and enlarging percutaneous penetrations comprises an elongate dilation member which receives an elongate expansion member in an axial lumen thereof. The dilation tube includes a tubular braid which usually comprises a mesh of non-elastic filaments which are radially expandable from a small diameter configuration to a large diameter configuration and which is optionally covered by a removable sheath. The dilation tube is percutaneously introduced to a target site within a patient's body, usually within the abdomen in a laparoscopic procedure. The sheath (if present) is then removed, and the tubular braid thereafter radially expanded by axial insertion of the expansion member through its lumen. The tubular braid is anchored by axial shortening of the mesh and remains in place to permit subsequent exchange of dilation members to provide for different diameter access lumens.

Abstract: Disclosed is an ultrasonic surgical instrument that combines end-effector geometry to best affect the multiple functions of a shears-type configuration. The shape of the blade is characterized by a radiused cut offset by some distance to form a curved geometry. The cut creates a curved surface with multiple asymmetries causing multiple imbalances within the blade. Imbalance due to the curve of the instrument is corrected by a non-functional asymmetry proximal to the functional asymmetry. Imbalance due to the asymmetric cross-section of the blade is corrected by the appropriate selection of the volume and location of material removed from a functional asymmetry. The shape of the blade in one embodiment of the present invention is characterized by two radiused cuts offset by some distance to form a curved and potentially tapered geometry. These two cuts create curved surfaces including a concave surface and a convex surface.

Abstract: A method and stent for treating a lumen, the stent comprising a plurality of continuous filaments braided together, at least one filament comprising a tapered filament having at least one first region having a first, relatively-larger cross-sectional area and at least one second region having a second, relatively-smaller cross-sectional area. The stent itself may have a tapered diameter, such as from one end to the other.

Abstract: The device for fixing a thread (25) to a surgical needle (22) includes a bearing piece (2) and a punch (16). The bearing piece (2) has a housing (10) adapted to receive a needle (22) so as to immobilize it when the punch (16) comes into contact with the needle.

Abstract: A surgical suturing apparatus includes a needle, a needle holder which also serves as a support for suturing material, and an elongate handle. The needle defines a passageway through which the suturing material extends. The passageway has an outlet at the distal end of the needle.

Abstract: A powered surgical handpiece (20) designed to actuate cutting accessories (22) such as those used to perform endoscopic surgery. The handpiece includes a housing (24) that contains a motor (26). The motor is within its own housing (46). A motor rotor (88) extends out of the motor housing (46) and engages a gear reduction assembly (76). The gear reduction assembly includes a planetary gear assembly for which the motor rotor (88) is the sun gear. The motor housing (46) is formed to have integral therewith a ring gear (96) that is located around the portion of the motor rotor that extends out of the motor housing. There is a valve (44) for regulating suction flow through the handpiece. The valve sits in a valve bore (110) that is closed at one end. There is also coupling assembly (28) for releasably holding the cutting accessory to the housing so that the cutting accessory engages with the gear assembly.

Abstract: An endoscopic surgical instrument includes a flexible tube, a grasping and fastening end effector coupled to the distal end of the tube, and a manual actuator coupled to the proximal end of the tube. The manual actuator is coupled to the end effector by a plurality of flexible cables which extend through the tube. The tube contains a lumen for receiving a manipulable endoscope and the end effector includes a passage for the distal end of the endoscope. The end effector has a store for a plurality of male fastener parts, a store for a plurality of female fastener parts, a rotatable grasper, a rotatable fastener head for aligning a female fastener part and a male fastener part with tissues therebetween, and a firing member for pressing a male fastener part through tissues grasped by the grasper and into a female fastener part.

Abstract: Devices and methods are provided for diagnosing and repairing mitral valve defects such as mitral valve regurgitation. According to an exemplary method, mitral valve function is visualized by transesophageal echocardiography. A catheter (10) is inserted along the venous system of the patient through the left and right atria (a, b) into the mitral valve (26). A suction tip (25) grasps the leaflets (28, 30) of the mitral valve (26) to immobilize and juxtapose the leaflets (28, 30) at a point simulating a stitch, and the mitral valve (26) is again observed to confirm that fastening at that point will repair the prolapse or other defect. The mitral valve leaflets (28, 30) are then fastened together via a fastener such as a staple (44) or shape memory rivet (44). The fastener (44) may be inserted by a stapling assembly (40) in the catheter (10), or by a separate stapler (40) that is inserted along an arterial path from the opposite direction and guided along a transcardiac rail to the immobilized point.

Abstract: An apparatus for guiding a high speed liquid jet used in forming ophthalmic incisions includes an instrument body having an elongated rectangular portion and a tapered end portion. An applanation suction ring assembly is secured to the tapered end, and is provided with a stepped opening extending axially therethrough. A carriage assembly extends longitudinally within the instrument body, and a pair of high precision crossed roller slides join the carriage and body to permit lateral translation of the carriage. A micro-motor assembly secured within the body is joined to a pinion gear which engages a rack gear joined to the carriage to drive the carriage in lateral translation. The carriage includes a proximal connector for a high pressure fluid hose, and a jet nozzle assembly extending from the distal end. A plurality of guide members are provided, all having common structural features adapted to engage the stepped opening of the distal end of the instrument body.