Abstract: A securing device for medical and surgical use has two parts which may be separate or integrally connected, one part including an eye (3) with a latching pawl (4) and the other part including a flexible strip (1) with ratchet teeth (2) so that the strip can be advanced through the eye to adjust the effective length of the flexible strip, but is locked against reverse movement. In one embodiment the parts are integral and a needle (7) is attached to the free end of the flexible strip, the device being a surgical suture. In another embodiment the parts are separate and are adapted to engage respective body parts of a patient which are to be held together by the device.

Abstract: A method and apparatus for elevating, approximating and/or restraining internal organs or structures, and more particularly for treating female urinary stress incontinence are provided. The apparatus include an anchoring device having an elongated suture with an anchor at each end thereof and a cinching member therebetween for adjusting the operative length of the suture, an articulating apparatus for applying the anchoring device during an endoscopic or laparoscopic procedure, and an apparatus for drawing the suture relative to the cinching member after it has been emplaced.

Abstract: To reinforce a line of surgical staples in host tissue, a strip of xenogeneic or autogenic tissue, such as cross-linked pericardium or dura mater harvested from horses, cows, pigs, sheep and humans, is appropriately adhered to the apposed surfaces of a staple cartridge supporting jaw and an anvil jaw of a surgical staple gun so that when tissue to be excised is positioned between the jaws and the staple gun is fired, the staples will penetrate the two layers of animal tissue and the intervening host tissue. Actuation of the cutting blade on the stapler or the use of a separate cutting instrument severs the tissue and the two layers of animal tissue along the staple line. When used in performing a lung reduction procedure, the animal tissue reinforcing strips create an air-tight seal about the staples preventing air leaks.

Abstract: A method and apparatus for placing and tying a knot such as laparoscopy knot. A knot pusher assembly including an outer tube and an inner tube are positioned, and a plunger assembly is plunger through the knot pusher assembly. The plunger assembly includes a knot carrier having an at least partially formed knot with a free end. The free end is placed around the object to be tied and grasped with a clamp. The knot is released from the knot carrier and the free end is pulled back through the partial knot to complete and tighten the knot. The knot is tightened and placed using the knot pusher assembly, and the free end is cut by placing it into aligned slots on the outer tube and inner tube, and rotating the inner tube in relation to the outer tube to unalign the slots.

Abstract: This invention provides for a novel retractable, telescoping, surgical needle cover and a collapsible needle, such that the sharp tip of the needle is covered after use thereby protecting the user from accidental needle sticks. In one embodiment, the needle cover is hollow and holds the needle at the tip. When the sharp tip is struck on a hard surface, the needle collapses inside of the needle cover. A second embodiment of the invention provides for a cover which slides back and forth along the length of a needle and is held in a forward position by a lever which is movably disposed within a groove at the base of the needle. In the third embodiment, the needle cover only partially the covers the outer surface of the needle, and when the needle is held by a needle holder such that the needle holder contacts both the cover and the needle, then the needle tip is exposed.

Abstract: Apparatus and methods of use for reducing bleeding from the situs of a percutaneous arterial puncture in a living being, with the opening in the arterial wall having been closed by a closure including at least one portion of a suture extending out of the puncture. The apparatus basically comprising a mass of material which inhibits the flow of blood therethrough, e.g., collagen, a carrier for carrying the suture portion through the mass of material, and means for holding the mass of material with respect to the suture portion so that it closely engages tissue contiguous with the puncture tract. The means for holding may comprise a knot in the suture portion, or can be a releasably securable member for location on the suture portion. In one embodiment the carrier comprises a piercing member, e.g., a needle, arranged for location within the interior of the artery for passage thereout through the wall of the artery and through the mass of material to carry the suture portion therethrough.

Abstract: The present invention pertains to an apparatus and method which enable the performance of vertical banded gastroplasty (VBG) without the use of staples. Further, a laparoscopic instrument which can be used in combination with the VBG apparatus and method is also disclosed.The laparoscopic instrument can also be used in combination with surgically functional elements other than the VBG apparatus. A particular advantage of the laparoscopic instrument is that surgically functional elements attached at the leading edge of levered jaws of the instrument can be rotated at least 180 degrees in a plane which is substantially parallel to a plane passing horizontally through the longitudinal centerline of the levered jaws.

Abstract: A device for sealing incisions in the body of a patient wherein the device includes a bioabsorbable sealing member having an elongate shaft member and an elastomeric and flexible balloon member. The device may also include a preformed or injectable collagenous material associated therewith to hemostatically seal the incision in the body of the patient. The shaft member may include one or more lumens extending therethrough in flow communication with one or more balloon members thereon to provide a relatively simple device which effectively seals an incision in the body of a patient.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. A particular utility is effected in the approximation of the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off.

Abstract: A suturing guide includes opposing guide sections having openings for guiding placement of a suturing needle. In docking a dog's ear, the suturing guide is placed in position, used as a guide for a cut and, via spaced guide openings, acts as a guide for positioning of sutures back from the edge of the cut and with desired lateral spacing. The opposing guide sections may be supported and positioned by an included, spring-biased support assembly, or may be applied independently of a support assembly. Straight and curved edge guide sections and a variety of alignment and retention features are described.

Abstract: Disclosed is a device for delivering tissue adhesives to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or animal. Also disclosed is a method of delivering tissue adhesives to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or animal. The method is particularly suited to sealing perforations in vascular walls, such as after arterial access for Percutaneous Transluminal Coronary Angioplasty (PTCA), Percutaneous Coronary Angiography and Percutaneous Coronary Atherectomy and similar diagnostic and therapeutic procedures.

Abstract: The surgical instrument system disclosed is particularly useful for endoscopic procedures. In the preferred embodiment, a hemostatic clip applicator can be directly connected to a trigger assembly or indirectly connected to the trigger assembly through the use of an extension. The connection between the extension and the clip applicator is secured to prevent accidental release during the procedure. The applicator receives a longitudinal input and translates the input into relative component motion through the use of gearing to apply the clips. The handle stem assembly in an alternative embodiment has a drive rod configuration that connects to a closure member so as not only to provide the distal biasing force, but also to provide, if needed, a proximal pulling force to assist in release of the jaw if it becomes necessary.

Abstract: A suture applying device comprises a shaft having a nose piece attached at its distal end. The shaft and the nose piece are separated by a transition region, and a needle entry lumen in the shaft permits a flexible needle to be introduced in the distal direction. The needle is able to cross the transition region and penetrate tissue held therein and enter into a return lumen in the nose piece. The return lumen is U-shaped and acts to bend the flexible needle as it is advanced. In this way, the needle passes from the nose piece through the transition region in a proximal direction, and is able to pass through tissue within the transition region generally on the opposite side of a tissue puncture from the first suture passage. The needle then exits from the device, permitting the suture attached to the needle to be drawn fully through the device. The suture may then be tied in order to close and seal the tissue penetration.

Abstract: A surgical instrument for applying sutures including an elongated housing having a proximal end and a distal end, means associated with the distal end of the elongated housing for carrying at least one needle, the needle carrier means being movable between a retracted position and an extended position, at least one needle positioned on the needle carrier means, and means associated with the needle carrier means for moving the needle carrier means to the extended position to deploy the at least one needle such that upon movement of the needle carrier means by the moving means, the needle carrier moves from the retracted position to the extended position whereby the at least one needle is caused to travel through a tissue engaging path in one continuous motion.

Abstract: A surgical stent is provided for use in supporting the walls of a tubular organ during anastomosis. The stent includes a tubular body having a diameter adapted to be about equal to the diameter of the organ and having opposed axial ends a circumferential ridge intermediate the ends. The ridge has a diameter adapted to be greater than the diameter of the tubular organ so that when the tubular organ is supported on the body, the ends of the tubular organ may be joined together along the ridge, and are everted to facilitate suturing.

Abstract: A surgical instrument facilitates tying of a knot in a length of suture material at a remote surgical location. The instrument is comprised of an inner rod having a length of suture wrapped over the rod in a particular pattern. A needle may be secured to a free end of the suture and the pattern of wrapping the suture on the rod enables loops of suture to move off the rod end and over the needle to form a knot in the suture. The inner rod is received in an interior bore of an outer rod for manually controlled reciprocating movement therein. The inner rod is manually retracted into the interior bore of the outer rod to cause the outer rod to move the loops of suture off the inner rod end and over the needle in forming a knot in the suture.

Abstract: An endoscopic ligating and dividing instrument includes an endoscopic portion and a non-endoscopic portion. The endoscopic portion includes clip closing jaws for applying at least two surgical clips to body tissue, pusher rods for loading clips into the jaws, a movable hook to catch and position the body tissue, and a knife for dividing the body tissue between the surgical clips. The non-endoscopic portion includes actuators responsive to manual actuation by a user.

Abstract: A device for non-surgical sealing of the interstice in the wall of a vessel is provided. The device includes a tubular, resorbable collagen plug 4 having longitudinal cut 8 in the form of a V. The device can further include applicator 5. The opening of cut 8 of plug 4 is located on the peripheral portion of plug 4. The internal diameter of plug 4 corresponds to the external diameter of catheter 3 which is introduced into vessel 1. The external diameter of plug 4 corresponds to the external diameter of applicator 5. Plug 4 includes inner and outer layers of resorbable collagen which have differing swelling rates. Applicator 5 includes longitudinal cut 10 in the form of a V. The opening of cut 10 is located on the peripheral side of applicator 5 relative to vessel 1.

Abstract: A bone anchor for securing a suture to a bone comprising a head portion and a shaft. The head portion includes a flat head portion for impeding axial migration of the bone anchor into the bone and a dome portion having a tunnel for receiving a suture. The shaft secures the bone anchor to the bone. It extends from the head portion to a flat, distal end. The shaft includes a plurality of tine segments disposed in planes substantially perpendicular to the longitudinal axis of the bone anchor and a plurality of grooves extending along the shaft that divide each of the plurality of tine segments into a plurality of tines. Each of the plurality of tines has an upper surface substantially perpendicular to the longitudinal axis of the anchor, a frustroconical portion, and an arcuate junction defined by the intersection of the upper surface and the frustroconical portion.

Abstract: A closed end surgical cryoprobe instrument may have a probe shaft diameter of 3 millimeters or less and can achieve and maintain freezing zone temperatures close to that of the liquid cryogenic refrigerant. Using sub-cooled liquid nitrogen at approximately -208.degree. C. freezing zone temperatures as low as -206.degree. C. can be achieved in under 1 minute. The liquid nitrogen supply tube is provided with a plurality of small vent holes to vent gas formed or present in the refrigerant supply tube to the return refrigerant flow channel. The vent holes also allow small amount of liquid nitrogen to vent into the return flow channel to further reduce the temperature differential between the sub-cooled liquid nitrogen supply and the counter current flowing return refrigerant. Heat transfer is maintained through nucleate boiling. In place of vent holes, narrow slits may be provided in the supply tube. Alternatively, a sintered porous metal supply tube can be used as the vent means.