Abstract: A tube knot applicator for use in endosurgical procedures. The tube knot applicator has an elongated tube member having a distal end and a proximal end, as well as an axial passage therethrough. The tube member has slits for partially collapsing the distal end of the tube as well as a removable plug mounted in the distal end of the tube to prevent the distal end of the tube from collapsing by supporting distal slitted end. A suture having at least one slip knot and at least one locking knot is mounted in the tube knot applicator with the knot tied about the collapsing means. A sleeve is mounted to the distal end of tube knot applicator over the suture knot and the distal end.

Abstract: A surgical instrument for performing a circular anastomosis is disclosed. The instrument is provided with sealing means to permit use during endoscopic procedures. The first seal is fabricated from polyethylene foam, is disposed about an elongate member and is in at least partial contact with an inner surface of a compression member. The second seal is an O-ring seal configured and dimensioned to at least partially contact an outer portion of the compression member and an inner portion of an outer tube. The second seal is disposed intermediate of the compression member.

Abstract: An occlusion device for percutaneous transluminal correction of intracardiac and vascular septal defects is disclosed. The device comprises a pair of opposed occluders that are connected to one another using an interconnection that allows the occluders to move relative to one another. Additionally, a means for fluoroscopically visualizing and distinguishing the individual occluders of the device is also disclosed.

Abstract: A guiding catheter exchange device allows the exchange of a coronary guiding catheter while the coronary guide wire is left in place across an obstruction in the coronary artery. In performing percutaneous transluminal coronary angioplasty, a guiding catheter is placed selectively into either the right or left coronary artery. The guide wire is advanced down the coronary artery and across the obstruction. The exchange device of the present invention allows the guiding catheter to be exchanged and while the wire is still in position across the obstruction. The exchange device has a short bore at its distal end portion which allows the exchange device to be routed into the patient's artery upon the coronary guide wire. The exchange device then provides adequate structure and support for exchanging different size guiding catheters.

Abstract: Apparatus is provided for applying a surgical clamp during endoscopic or laparoscopic procedures which includes a handle portion, an endoscopic portion extending longitudinally from the handle portion, and a surgical clamp detachably mounted adjacent a distal end of the endoscopic portion. The surgical clamp includes opposed cooperating jaw members which are movable between an initially closed position and an open position. Structure is associated with the endoscopic portion of the apparatus for detachably engaging the surgical clamp and a mechanism is provided for moving the opposed cooperating jaws between the initially closed position and the open position and for moving the engaging structure between a disengaged position and an engaged position. Preferably, a distal end portion of the endoscopic portion of the apparatus is adapted to articulate relative the longitudinal axis of the endoscopic portion for increasing the range of operability of the apparatus during surgical procedures.

Abstract: A pre-tied suturing knot for use with a surgical needle for endoscopic procedures and the method for making and using the pre-tied knot for tying the suture in situ. The pre-tied knot is tied from suturing thread and surrounds the shaft of a needle holder or grasper. A needle holder is placed on the U-shaped loop and the U-shaped loop or bight is pulled back upon itself to create a first loop, a second loop and two loopholes. The distal end of the suture thread is threaded over the proximal end and through the loopholes creating the nascent knot. The pre-tied knot is utilized after the tissue has been pierced with the needle. Thereafter, the needle holder is withdrawn from the suturing site, thereby pulling the suture thread against and through the tissue edges and moving the pre-tied knot along the shaft of the needle holder over the clamp and into position near the suturing site.

Abstract: A method of making a hemostatic plug for placement at a site where hemostatic treatment is indicated. The method comprises rolling a sheet of a hemostatic material a plurality of turns onto a generally cylindrical forming tool to thereby produce a rolled hemostatic plug having an opening therethrough along its longitudinal axis. In addition to employing one sheet of hemostatic material having a single density to form a plug, two sheets of hemostatic material having different densities can be rolled in tandem to each other on the forming tool, with one sheet overlapping an exposed wedge portion of the other sheet. The plugs thus formed can be longitudinally compressed if subsequent longitudinal expansion is desired. A typical placement site for which the plug is preferably employed is a puncture wound wherein an entry penetration of an artery and a tissue channel leading thereto are present.

Abstract: A surgical instrument for performing a circular anastomosis is disclosed. The instrument is provided with sealing means to permit use during endoscopic procedures. The sealing means includes a first, O-ring seal disposed intermediate of a compression member, wherein the first seal is configured and dimensioned to at least partially contact an outer portion of the compression member and an inner portion of an outer tube. The second seal at least partially disposed proximal the first seal and has a first diameter portion, a second diameter portion and is disposed about the compression member. The compression member has at least one aperture which the second seal is adapted to engage.

Abstract: An endoscopic surgical apparatus capable of ligation and division. The apparatus has a frame and a tubular shaft attached to said frame. Also attached to the frame is a handle. The apparatus has ligating means and cutting means. Actuation means are mounted to the apparatus for actuating both the ligating means and the cutting means. The apparatus has a clutch means capable of enabling the actuating means to switch between a first mode for actuating the ligating means and a second mode for actuating the cutting means. The cutting means is preferably an extendable J-hook and blade assembly. The cutting means and ligating means are preferably rotatable with respect to the frame. The ligation and division apparatus may be used to ligate and cut blood vessels or tissue in a mammalian body cavity during a surgical procedure.

Abstract: A pyloroplasty/pylorectomy shield having a base member and a proximally extending shield member. The pyloroplasty/pylorectomy shield has attachment means for engagement with a circular stapler. The pyloroplasty/pylorectomy shield also has dilation means for progressively dilating a sphincter. The pyloroplasty/pylorectomy shield is used with a circular stapler to perform a pyloroplasty/pylorectomy. Also disclosed is a method of performing a pyloroplasty/pylorectomy using the pyloroplasty/pylorectomy shield of the present invention. The pyloroplasty/pylorectomy shield has numerous advantages including reduced trauma, decreased misalignment resulting in improved stapling and improved positioning of the pyloroplasty/pylorectomy.

Abstract: A handle for use in implanting a prothesis has an elongate body portion and a post-retaining structure at the end of the body portion. The post-retaining portion or structure includes a core member which has a bore formed therein to receive a post connected, for example, to a broach or rasp. The core member also includes a channel formed therein in communication with the bore and a pin movable within the channel between a locked position at the distal end of the channel in communication with the bore and a released position. A spring and a collar are provided where the collar is adapted to slide over the core member, move the pin within the channel and retain the pin in the locked position while the spring is adapted to bias and/or move the collar toward the front end of the core to retain the pin. A movable sleeve fits over the collar and spring and is provided with a shoulder to engage and move the collar to release the pin within the channel.

Abstract: A system, a closure, and method of use for determining the position of a blood vessel via a percutaneous puncture and for sealing the percutaneous puncture in the blood vessel. The system includes an introducer sheath and associated positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device enables the introducer sheath to be positioned at a desired position within the vessel. The deployment instrument includes a tubular carrier storing the closure. The carrier has a distally located free end to be extended via an introducer through the puncture and its associated tract. The closure comprises a radiopaque rigid anchor, a compressed collagen plug, and a thin filament connecting the two in a pulley-like arrangement. The carrier ejects the anchor through the introducer and puncture and then draws it against the free end of the introducer.

Abstract: An improved suture throw rundown tool particularly useful in laparascopic and similar surgical procedures is provided which includes an elongated shaft having a proximal end and a first distal tip, an elongated rod extending through the shaft in reciprocating relation therewith and having a proximal end and a second distal tip, and a control device connected between the shaft and the rod for controlling the relative disposition of the first and second distal tips. The first and second distal tips are specially designed to mate with each other in a first position and to be longitudinally offset relative to each other in a second position. In the offset position, a suture throw may be engaged by the distal end of one of the distal tips while the free ends of the suture emanating therefrom are extended through grooves connecting the distal end of the offset distal tip to its outer edge.

Abstract: A suture device including a hook needle, a body portion which fits within a wound site and a handle portion pivotally attached to the body portion. The needle is J-shaped with a long straight part and short curved part terminating in a pointed end. The long part of the needle slides in a channel in the handle portion and the pointed end moves axially toward and away from the handle with the curved part of the needle facing internal organs during closure of a wound site in an abdominal cavity.

Abstract: A surgical closure which can be repeatedly opened and closed, especially one for an abdominal incision, consisting of flexible fabric or plate-like securing means which can be firmly secured to the bodily tissue close to the incision but can be released therefrom and with a closure bringing together its end regions above the incision which can be opened and closed at any time, is to be improved in such a way that a completely pressure-tight closure is obtained but which may be opened as often as desired. This is achieved in that it is fitted with a securing component (15) surrounding the incision on all sides which has an opening (4) that can be placed above the incision and consists of a tube (5) of flexible material extending upward from and surrounding the opening (4) and the tube (5) itself acts as the closure or is fitted with such.

Abstract: A medical knot tying instrument having a first member including proximal and distal ends, a gripping mechanism for releasably gripping a first length of suture proximate the distal end of the first member and a holding mechanism for releasably holding a second length of suture proximate the location where the gripping mechanism grips the first length of suture but separated therefrom a predetermined distance toward the first member's proximal end. Gripping one length of suture using the gripping mechanism and holding a second length of suture using the holding mechanism, the instrument is rotated in one angular direction so that the second length of suture forms a loop around the instrument whereupon the second length is grasped using a separate grasping instrument.

Abstract: A surgical instrument for performing a circular anastomosis is disclosed. The instrument is provided with three seals to permit use during endoscopic procedures. The first seal is configured and dimensioned to at least partially contact an outer portion of a compression member and an inner portion of an outer tube. The second seal is disposed about the compression member and is located proximal of the first seal. The third seal disposed about an elongate member, is located proximal of the second seal and is fabricated from polyethylene foam.

Abstract: A generally sickle shaped needle having a short shank is disclosed. An optional perpendicularly aligned grooved needle holder may be utilized in combination with the needle to rapidly close deeply lying trocared fascial wounds to prevent sequela and hernia formation after laparascopic surgery.

Abstract: A surgical instrument having a surgeon operable control handle for advancing a needle to pierce tissue and to carry a ligature through the pierced tissue.

Abstract: A drive mechanism for an endoscopic surgical instrument which has a rotatable drive shaft and a mechanism for translating the rotational force of the shaft for applying fasteners to tissue during endoscopic surgery.