Abstract: A straight, cannulated drill guide having a slidable aiming arm is used to align a multi-functional drillhook for drilling a tunnel in the proximal humerus. The drillhook has a hook slot concealed on the distal end. A perforating suture hook is used to pierce the rotator cuff and to pass suture through the rotator cuff and into position for retrieval by the hook slot, which is activated after drilling the tunnel to pull the suture through tunnel. The rotator cuff is held taut and in position by a retaining suture.

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: A method and apparatus (10) for applying a preformed endless band (18) of elastomeric ligature material to an animal body part is provided, such method employing a motor to facilitate the winding of ligature material. The apparatus (10) includes a winding assembly (14) for winding the band (18), wherein a loop (20) of the band (18) is tightened by winding the band (18). A crimping assembly (16) for crimping a grommet (32) to secure the loop (20) is also disclosed. The invention allows the loop (20) to be quickly and tightly secured using pneumatic/electric tools or motors.

Abstract: A clip applier and method for ligating a tissue structure is provided. The applier has a two stage actuation. In the first stage, a tissue structure is positioned into the jaws of the clip applier The jaws close and lock to a preset force to compress and temporarily occlude the tissue structure. If satisfactorily positioned, the second stage is initiated in which a clip is advanced through the shaft of the clip applier in a closed position. At the distal end of the clip applier, the clip is opened slightly to capture the pre-compressed tissue structure, and is placed over the structure. The clip is then dissociated from the business end of the instrument. Preferably the clip comprises two leg members disposed in close proximity to one another joined from opposing directions by a connecting element. The connecting element restricts separation of the leg members with opposing spring members so as to provide substantially uniform parallel deflection of the leg members from each other.

Abstract: The present invention provides a suture clip for attachment to at least one suture comprising a suture clip body having a central longitudinal axis, a proximal end, a distal end, an inner surface, an outer surface and a proximal surface, wherein the inner surface forms a passage that is substantially parallel to the longitudinal axis and is connected to the outer surface by a longitudinal slot which extends from the distal end to the proximal end of the suture clip body and the proximal surface has a major dimension at least five times larger than the diameter of said suture and a collar disposed about said suture clip body engaging the outer surface of the suture clip body to deflect the inner surface to frictionally engage the suture. Also described herein are methods of using this suture clip in surgical procedures.

Abstract: A laparo-suture needle and method for use thereof. A medical suturing instrument employs an outer, hollow shaft having a laterally-disposed, elongate handle at a proximal end and an elongate, inner shaft disposed within the outer shaft. The inner shaft has a cutting edge at the distal end and extends out of the outer shaft at the proximal end, terminating in a spring-loaded push button. A lateral notch is formed in the inner shaft proximal of the cutting edge. The spring forces the inner shaft rearwardly so as to pull the notch within the outer shaft. By gripping the handle and placing pressure on the push button, the inner shaft is moved forward so as to expose the notch. A suture may then be placed in the notch so that the instrument grips the suture between the outer shaft and the inner shaft when the push button is released.

Abstract: A system for sealing a percutaneous puncture in a blood vessel in a living being and method of use thereof. The system includes a hemostatic closure, a blood vessel locator device for determining the position of the blood vessel via the percutaneous puncture, and a deployment instrument for deploying the closure within the puncture to seal the puncture. The vessel locator includes means for enabling blood from the vessel to flow therethrough so that the position of the vessel can be rapidly determined. Once the vessel has been located the deployment instrument, which includes a tubular carrier storing the closure, is extend into the puncture to deploy the closure. The closure basically comprises a radiopaque rigid anchor for location within the blood vessel, a compressed collagen plug for location within the puncture tract leading to the vessel, and a thin filament connecting the two in a pulley-like arrangement.

Abstract: A surgical instrument for one-handed preparation of an anastomosis in minimally invasive surgery has, from the distal end to the proximal end, an interchangeable insertion head (1), a staple holder (30) with U-shaped staples and with a circular groove with thread placed in it, an ejector unit, an gently bendable, adjustable and fixable joint (6), an annular knife retained on the ejector unit, a hollow-cylindrical holder part that is axially displaceable in the annular knife and has a number of elastically resilient, radially pivotable gripper and holder arms (20), a circular-cylindrical shaft (7) mounted on the proximal end of the joint (6), an adjusting and fixing device (8) with a hand wheel (80) mounted on the proximal end of the hollow shaft, and a handle (9) with a toggle lever mechanism (90, 93) pivotably connected to it. (FIG. 1).

Abstract: In annuloplastic surgery, the holder which supports the annuloplasty ring during the suturing of the ring to a heart valve annulus is released from its handle, and reattached for subsequent removal, without rotary or axially compressive stress on the holder. This is accomplished by inserting laterally movable locking tabs from the handle into the holder. The locking tabs are the ends of a Y-shaped clip which translates the axial movement of a locking button on the handle into a transverse holder-engaging movement.

Abstract: An endoscopic surgical system which includes an instrument for carrying out a step in the procedure. The instrument is power operated by a supply source, and there is contained a mechanism used to conduct the power from the supply source to the instrument. The system includes a sensing mechanism attached to the instrument and used to monitor and to control the operation of the instrument.

Abstract: A soft tissue anchor delivery apparatus includes a gripping device having fingers at the distal end and configured such that they can hold a soft tissue anchor about the head portion of the anchor. An actuating tube slides over the gripper and the fingers, thus holding the fingers and the contained soft tissue anchor within the bore of the actuating tube. A pushrod is placed within the bore of the gripper. The pushrod has a countersunk head that is shaped such that it is a close fit for the head of the soft tissue anchor. The pushrod is connected to a tube having a bore so that the actuating pin of the soft tissue anchor can be pushed down into the head of the anchor. The pushrod is spring loaded so as to allow the pushrod to be driven distally upon retraction of the actuating tube, thus driving the anchor free of the deployed fingers and hence of the entire delivery system.

Abstract: A surgical clamp has pivoting jaws with undulating arrays of teeth that are interdigitating and offset with relation to each other. This clamp structure assures a firm, non-slipping grip in the presence of blood and body fluids during surgery. The inner surfaces of the jaws are concave to allow the clamp to grasp more tissue or organ that would be possible with flat inner surfaces. Laparoscopic and open surgery embodiments are included. An alternative to the embodiment is a clamp having openings through which tissue or an organ can protrude to allow an even greater amount of tissue or organ to be grasped.

Abstract: Disclosed is a device for delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or other animal. Also disclosed is a method of delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity. 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: A suture anchor system and procedure for securing a suture, into to extend from a bone cortex surface. The system includes forming a hole into a bone cortex surface that is of a diameter and depth to provide a wall surface area that is at least as great as the surface area of an end section of a suture or sutures fitted therein, and, by filling the hole with an adhesive that is allowed to cure, a suture mounting is provided that will have a pullout strength or purchase that is greater than a load as is anticipated to be applied thereto when the suture is used to connect a ligament, or the like, to the bone.

Abstract: A clip applicator adapted to apply and remove C-shaped scalp clips from a surgical incision site, wherein the clip applicator includes a body, a trigger and a lever mounted on the body and mutually operable between respective first and second positions relative to the body. The lever includes a clip-engaging portion disposed at a distal end thereof and a trigger-engaging portion disposed at a proximal end thereof. The lever is movable from the lever first position to the lever second position in response to the trigger moving from a trigger first position to a trigger second position. The clip applicator further includes a magazine that is releasably fastened to the body. The magazine is adapted to store a plurality of clips, and to serially dispense the clips from the magazine.

Abstract: Disclosed is a device for delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or other animal. Also disclosed is a method of delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity. 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: A knotless suture anchor assembly for the attachment or reattachment or repair of tissue to a bone mass. The assembly allows for an endoscopic or open surgical procedure to take place without the requirement of tying a knot for reattachment of tissue to bone mass. A spike member is inserted through tissue mass through a loop and inserted into a dowel-like hollow anchoring sleeve which has been inserted into a bone mass. The spike member is securely fastened or attached to the anchoring sleeve with a ratcheting mechanism thereby pulling or adhering (attaching) the tissue to the bone mass.

Abstract: A surgical method and tools for anchoring a suture to bone is disclosed. The method includes forming an opening through a top surface of the bone, positioning a suture within the opening and crimping a region of the top surface of the bone surrounding the opening to anchor the suture within the opening. The tools used with the disclosed surgical method include a punch, a broach, a guide and a swage. The punch and the broach are used to create a uniform diameter opening in the bone by compressing bone material. The guide is used to position a suture, preferably having a shoulder, in the opening. Finally, the suture is used to crimp the region of the top surface of the bone surrounding the opening.

Abstract: A suturing device includes a shouldered surgical needle where the shoulder has a cross sectional transverse dimension. A suture is attached to a distal portion of the needle. A needle catch having a flexible aperture with a relaxed dimension which is smaller than the cross sectional transverse dimension of the shoulder allows insertion of the needle into the flexible aperture by expansion of the flexible aperture to a stretched dimension which is substantially equal to the cross sectional transverse dimension of the shoulder. The shoulder on the needle prevents removal of the needle from the flexible aperture in a direction which is the reverse of its direction of insertion into the flexible aperture.

Abstract: The present invention is directed to a surgical suture instrument specifically designed for suturing body tissues in enclosed surgical operations. The instrument includes a casing with a slot or housing a suture needle. The needle includes a first puncture end and a second manipulation end. The needle is pivotally positioned on an axis within the casing, such that the puncture end may be exposed or retracted as needed. The casing also includes equipment to manipulate the needle within the casing.