Abstract: A stapler device includes a manually grippable handle containing a drive and a trigger to activate the drive mechanism, a barrel fixed to the handle, a guide for holding a staple to be ejected and formed to accommodate a suture thread fixed to the staple, and an ejector driven by the drive through the barrel for ejecting a staple out through the guide into a bone to enable the suture, so anchored to the bone, to be used for various medical operations.

Abstract: In order to destroy vascular deformations in the human body, a clamp is provided which is made from titanium. The clamp is expanded in the relieved state and is transferable into the clamping position by a clamping ring, which is displaceable along the clamp in the attached state. The clamp is introduced into the body by a probe, which has a tubular casing and a positioning bar guided therein. The clamp is transferred into the region of the deformation and applied at the application location as a result of the clamping ring being transferred into the clamping position. The transfer is caused by a relative movement between tubular casing and positioning bar. The probe is then released from the positioned clamp.

Abstract: A method for producing a detachable surgical needle-suture combination of the type incorporating a fluid swellable suture material is capable of producing needle-suture attachments which conform to the prescribed minimum pull-out forces for detachable needle-suture combinations as set forth in the U.S. Pharmacopeia. Generally, the method includes the steps of providing a surgical needle and a fluid swellable suture, immersing an end portion of the suture into a liquid solution whereby the suture end portion swells and assumes an expanded condition, positioning the suture end portion in its expanded condition into an aperture formed in the blunt end of the needle and swaging the blunt end of the needle to cause deformation of at least a portion of the blunt end and engagement with the suture end portion to effect needle-suture attachment.

Abstract: A method and apparatus for elevating, approximating and/or restraining internal organs or structures, and more particularly for treating female urinary stress incontinence is provided. The invention includes an anchoring device having an elongated suture with an anchor at each end thereof and a cinching member therebetween for adjusting the length of the suture, an apparatus for applying the anchoring device, and an apparatus for drawing the suture relative to the cinching member after it has been emplaced. The method involves securing a first anchor to a first structure, such as the vaginal wall, securing a second anchor to a second structure, such as Cooper's ligament, and drawing the suture relative to the cinching member to approximate the first and second anchors, and thereby move the first structure and the second structure into juxtaposition so as to approximate them.

Abstract: A slidable kit for endoscopic ligation of gastric and esophageal varices comprises an endoscope-inserting cylinder and a ligating device coaxially and integrally secured to the endoscope-inserting cylinder, where the ligating device is in such a structure that a slide cylinder having an annular rib on the outer periphery at the rearward end is inserted into an outer cylinder having an annular rib on the inner periphery at the forward end; an inner cylinder is inserted into the slide cylinder; the outer cylinder and the inner cylinder are integrated together at the rearward ends and firmly secured to the forward end of the endoscope-inserting cylinder; an elastic O ring is mounted on the outer periphery at the forward end of the inner cylinder; a seal ring is provided at the rearward end of the slide cylinder, thereby keeping an annular space between the outer cylinder, the inner cylinder and the slide cylinder hermetic; the slide cylinder is slidable forwards by a liquid introduced into the annular space thro

Abstract: A trocar wound closure device includes an elongated body having a distal end for insertion through a trocar puncture wound, a proximal end, and a first and second retractable needle holders disposed at the distal end of the body. The needle holders are movable between a retracted position and an extended position. An actuator disposed at the proximal end of the body moves the needle holders from the retracted position to the extended position, so that the needle holders can be retracted to allow the device to be inserted through a trocar wound preferably through a cannula inserted into the wound, and extended to position the needles adjacent the wound, to allow the wound to be sutured.

Abstract: A surgical instrument, guide and method capable of being used for closure of peritoneum fascia, occlusion of bleeding vessels such as inferior epigastric, and for all uses related to accurately passing suture material through a guide into tissue with the tip of the surgical instrument in a standard suture/needle driving position with a sharp tip that opens and closes with the surgeon grasping suture material with the sharp tip and inserting the tip/suture through tissue until the tip is seen through the peritoneum by direct vision, wherein the suture is released by opening and withdrawing the tip from the guide, and recovered by using the guide to redirect the tip and puncturing the tissue opposite the first point of insertion wherein the tip grasps the suture and pulls the suture through the guide, and outside the wound providing for rapid closure of the surgical incision, and wherein a guide insertable within the wound to be closed guides the surgical instrument at a predetermined angle from the longitudina

Abstract: A device and method are provided for the surgical suturing of narrow incisions that penetrate through a plurality of tissue layers. An elongated, "J"-shaped needle, through which suture material is threaded, is inserted into the wound, bringing the tip through one or more layers of tissue on one side of the wound and pulling suture material up through the wound. After repeating these steps on the other side of the wound, the suture material is knotted. A slidable locking member serves the dual purpose of covering the tip of the suture needle when not in use and also of maintaining pneumoperitoneum.

Abstract: Apparatus and method for forming a compression anastomosis of a hollow organ. The apparatus comprising a first collapsible member movable between an expanded configuration and a collapsed configuration, the first collapsible member having a longitudinal bore defined by an inner surface, a first mating member, locking structure disposed on the first collapsible member for locking the first collapsible member with the first mating member, a second collapsible member movable between an expanded configuration and a collapsed configuration, the second collapsible member having a longitudinal bore defined by an inner surface, a second mating member, locking structure disposed on the second collapsible member for locking the second collapsible member with the second mating member, and the first member adapted to interlock with the second member.

Abstract: A Verres needle suturing device. The spring loaded probe of a Verres needle assembly is modified to include an angled guide for guiding the end of a piece of suture material from the channel of the probe out of the opening of the probe so that it can be snared by a snare introduced into the surgical site. The invention is particularly useful for relatively inaccessible surgical sites, such as result from endoscopic and laparoscopic surgery.

Abstract: An instrument for facilitating the use of sutures in laparoscopic surgical procedures includes a hollow housing defining an internal cavity. A plunger extends within the cavity of the housing and is supported therein for relative sliding movement between first and second axial positions. A spring disposed within the cavity urges the plunger to the first axial position relative to the housing. An introducer needle is secured to the housing and extends co-axially therefrom, terminating in an angled tip having a sharp point. An actuator tube is disposed within the introducer needle and is secured to the plunger for axial movement therewith relative to the housing. A flexible wire is disposed within portions of the actuator tube and is secured thereto for axial movement with the plunger. The wire is folded back over itself to form a looped end. When the plunger is in the first axial position, the looped end of the wire is withdrawn within the angled end of the introducer needle.

Abstract: In a suturing instrument for remote suturing of the edges of tissue wherein a stationary and a pivotal jaw are arranged at the distal end of an instrument shaft and a suturing wire guide channel extends through the instrument shaft for supplying a suturing wire from the instrument's proximal end to the stationary jaw and wherein an outer tube is movably disposed on the instrument shaft for engaging the pivotal jaw to move it toward and from the stationary jaw and hold the jaws in an operating position in which they are arranged parallel to one another, the jaws have spaced wire guide grooves with groove bases defining, in the operating position of the jaws, a screw line which is followed by the suturing wire when it is advanced by advancing means operated by a handle disposed at the proximal end of the suturing instrument.

Abstract: An apparatus is disclosed for endoscopic application of surgical staples to body tissue in laparoscopic hernia surgery, preferably with surgical mesh. The apparatus includes a staple storage cartridge supported on a pivotal support system at the distal end of the endoscopic section. An elongated pusher system extends from the frame to the endoscopic section and individually advances the staples distally. A pair of legs project distally from the pusher plate to engage the staple during closure to prevent unwanted roll or deformation of the staple. A trigger system actuates the pusher. An anvil structure having rounded anvil legs to match the configuration of the staples provides for individually closing each staple to encompass at least a portion of the surgical mesh and to penetrate the body tissue to attach the portion of the mesh to the body tissue. The staple storage cartridge may be pivoted with respect to the longitudinal axis of the endoscopic section from 0.degree. to about 20.degree., 45.degree.

Abstract: An implantable spine fixation apparatus and method, the apparatus including a pair of longitudinal rods placed on each side of the spinous process. Several side arm clamps are attached to the longitudinal rods with their lateral arms extending outwardly from the longitudinal rods. Clamps are mounted to the lateral arms and both affixed to the bone of the spine and clamped to the lateral arms by bone screws inserted into the bone of the spine. Cross link plates are mounted to paired side arm clamps to secure the relative positions of the longitudinal rods. The method includes providing the bone screw with the optimal angular orientation for fixation of the bone screw to the bone. The method also includes adjustably affixing the implantable fixation apparatus relative to the spine for improving bone grafting.

Abstract: An improved surgical stapler for applying a suture to a tissue is provided. The surgical stapler includes handles and a stapling assembly for emplacing a suture and staples into tissue as a purse string suture. Retainer structure, for example, a plurality of guides are provided for releasably retaining a portion of the suture substantially adjacent to the handles. The suture may also be releasably retained substantially adjacent to the handles by passing the suture through a tubular member releasably mounted on one of the handles. A clamp may be used to clamp and secure the suture within the tubular member either before or after removal of the tubular member from the handles.

Abstract: In accordance with the present invention, there is provided new and improved apparatuses and methods for anastomosing living vessels. The preferred apparatus includes a ring-like body through which a first living vessel end is extended and everted back over and a second living vessel end which is drawn over the everted first living vessel end to place the lumen of these vessels in apposition. A plurality of fasteners are employed to clinch the vessel ends in sealed apposition at the ring-like body. These preferred fasteners are staple-like and have one leg located inside of the ring-like body but exterior of the first living vessel, and a second leg located exterior of the margin of the second living vessel at the ring-like body. The ring-like body may also be provided with at least one needle-like projection which may be adapted to either permanently impale and hold the vessel ends at the ring-like body or temporarily impale and hold the vessel ends until the fastener are employed.

Abstract: An apparatus for closing wide skin defects may be used with two long interdermal needles configured for insertion underneath skin close to margins of a skin defect. The skin closing apparatus may include two U-shaped retaining members configured as a flange connecting two legs and forming a U-shaped profile. Each of the legs may include a sharp hook at the end of the leg adapted for piercing the skin and engaging one of the long interdermal needles. Each retaining member may include a pivoting platform that pivots up to 20.degree. from an initial position indicated by a detent mechanism. A contracting mechanism such as a screw may connect the retaining members and approximate the interdermal needles, while bringing the skin margins together until final closure of the skin defect results. The skin closing apparatus may also include a clutch mechanism configured to disengage the screw from a knob or handle, when a predetermined force is met or exceeded.

Abstract: A ligating instrument includes a handle for securing a proximal end of a ligating device externally of the body with one hand, the ligating device defining a lumen for passage therethrough of a length of ligature material formed with a ligature loop for being disposed externally of a distal end of the ligating device to be positioned around anatomical tissue to be ligated within the body, and an operating member coupled with the ligature material for being manually moved with the same hand as that securing the ligating device proximal end to pull the ligature material through the ligating device to form a ligature with the ligature loop in the anatomical tissue.

Abstract: A surgical staple for securing a purse string suture to human tissue comprises a staple body of deformable material formed into a loop through which the purse string suture is threaded. The staple body includes a pair of legs which are deformable into an overlapping configuration upon insertion into the tissue to secure the staple body and the purse string suture to the tissue. Alternatively, the staple body includes two or more legs including barbed ends for anchoring the legs to the tissue. To secure the purse string suture, a plurality of staples is positioned about the periphery of the tubular section of tissue, the purse string suture is threaded through the loops in the staples, and the staples are driven into the tissue to secure the purse string suture thereto. In addition, surgical instruments for open surgery and endoscopic surgery are provided for applying the staples and the purse string suture to the tissue.

Abstract: An apparatus is disclosed for endoscopic application of surgical staples for fastening body tissue, especially vascular tissue. The apparatus includes a frame and an elongated endoscopic section connected to the frame and extending distally therefrom. A staple storage cartridge cooperates with the distal end of the endoscopic section and is selectively pivotal by the user. A staple firing mechanism advances an individual staple against an anvil for staple closure. Means are provided to prevent incomplete staple firing. Relative motion between the staple cartridge and the anvil clamps tissue to be stapled therebetween.The endoscopic section may be adapted for rotation about the longitudinal axis of the apparatus. Gaseous seal means located in the endoscopic section prevent escape of insufflating gas through the apparatus.