Abstract: A surgical clip applier and methods for applying surgical clips to a vessel, duct, shunt, etc., during a surgical procedure are provided. In one embodiment, a surgical clip applier is provided and can include a housing having a trigger movably coupled thereto and an elongate shaft extending therefrom with opposed jaws formed on a distal end thereof. The clip applier can include an advancer assembly disposed within the elongate shaft and configured to advance one of a plurality of clips disposed within the elongate shaft into the opposed jaws. A feeder shoe can be disposed within the elongate shaft and can be configured to engage and prevent the advancer assembly from moving to a proximal position after the advancer assembly has moved to a distal position to advance a proximal-most clip into the opposed jaws. This can indicate to a user that a clip supply of the surgical clip applier is depleted.

Abstract: A surgical clip applier and methods for applying surgical clips to a vessel, duct, shunt, etc., during a surgical procedure are provided. In one embodiment, a surgical clip applier is provided and can include a shaft having a proximal end and a distal end with opposed jaws thereon, a guide member disposed within the shaft and configured to guide a clip into the opposed jaws, the guide member having a channel formed in a surface thereof, and an advancer movably disposed within the shaft and configured to advance a clip over the guide member and into the opposed jaws, the advancer having a distal tip that slidably engages the channel for maintaining contact with a surgical clip as it is advanced into the opposed jaws. In other embodiments, the guide member can also include a proximal channel formed in a superior surface thereof.

Abstract: Embodiments of an endovascular device and of methods for treating an aneurysm therewith are described. In certain embodiments, an endovascular device includes a distal assembly coupled to a flow reducing member. In some embodiments, the distal assembly is composed of multiple engagement members that, when deployed within an aneurysm, engage an inner surface of the aneurysm. In certain embodiments, the engagements members are substantially parallel to a central axis of the distal assembly in a first position and shift away from the central axis to a second position, and the distal ends of some engagement members are substantially curled when in the second position. In certain embodiments, the flow-reducing member reduces blood flow from a blood vessel into the aneurysm. In certain embodiments the flow reducing member includes a membrane, which can include a porous section.

Abstract: Reinforcing lumen rings are configured and adapted for use in conjunction with a circular endoscopic stapling instrument having a staple cartridge assembly and an anvil assembly. The reinforcing lumen rings maintain anastomotic lumen, e.g. as formed by the circular endoscopic stapling apparatus, in an open condition. The reinforcing lumen rings can include an annular ring having an outer terminal edge and an inner terminal edge, the outer terminal edge having a diameter which is substantially equal to an outer diameter of the staple cartridge assembly and the inner terminal edge having a diameter which is substantially equal to an inner diameter of the staple cartridge assembly.

Abstract: Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot of the device can be inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot can carry suturing attachment cuffs with one end of the cuff adapted to receive a needle, while the other end receives suture. A portion of the foot and/or lumen of the shaft can receive a portion of the suture and can include friction reducing structure that aid with movement of the sutured during removal of the cuffs from within the penetration.

Abstract: A device for clamping a tissue, the device having a clamp (100) with at least one magnetic portion. In at least one embodiment, the clamp (100) has two oppositely polarized magnets (102, 104) and a mounting structure (106) for the magnets. In some other embodiments, a clamp has an electromagnetic collar (500) and a power source (300) to provide power to the collar (500) via an electrical connector (302). In at least some embodiments, the clamps (100) may also be electromagnetic.

Abstract: A single catheter mitral valve repair device for stabilizing a tissue portion and selectively applying a tissue fastener thereto. The single catheter mitral valve repair device of the present invention includes an extendable engagement tip having at least one vacuum port formed thereon, at least one deployable fastener in communication with the engagement tip, and at least one actuator member in communication with the port. The deployable fastener is capable of controllably engaging and fastening a tissue segment located proximal to the engagement tip.

Abstract: A method for deploying fasteners including the steps of providing a device having a handle and at least one actuator. The handle is connected to an elongated hollow housing having distal and proximal ends. The device has a first cartridge containing at least one fastener releasably connectable to the handle and an elongated pusher movable through the hollow housing from the distal to the proximal end for deploying the fastener from the distal end. The method includes increasing the stiffness of the pusher at a distal end thereof and advancing the pusher through the elongated housing to deploy the fasteners.

Abstract: Systems and methods for soft tissue to bone repairs, without knot tying.

Abstract: The present invention provides an apparatus for, and a method of, accurate positioning of endoscopic instruments. Accurate positioning of the instruments is accomplished through the inclusion of a steering ability within the device. After the endoscopic instrument is properly positioned, the present invention may use rapid exchange technology, soft locks, and mechanical locks to maintain the position of the endoscopic instrument. Rapid exchange technology is used to minimize displacement forces present on the guidewire or catheters. Soft locks and mechanical locks resist movements caused by displacement forces.

Abstract: A tensioning system for restricting the available volume of a gastric cavity includes a base material that is shaped and dimensioned for surgical attachment to surfaces on or within the body. Multiple tensioning members are incorporated into the base material, each of the tensioning members including a first end and a second end, wherein pulling upon the tensioning member will cause edges of the base material to be drawn together. The method for restricting the available volume of a gastric cavity includes securing edges of a tensioning system to the gastric cavity and drawing the edges of the tissue together to create a fold in the tissue.

Abstract: A tissue closing device includes a closure configured to close a hole penetrating a tissue membrane. The closure has a seal part for covering the hole penetrating the tissue membrane and a peripheral part of the hole from one surface side of the tissue membrane, and a deformable deformation part. The tissue closing device also comprises an arrangement device which removably retains the closure and closes the hole with the closure so as to arrange the closure in a living organism.

Abstract: An attachment assembly configured to secure an implantable support within a patient includes a length of suture, an anchor, a capsule, and a clasp. The suture has a leading end half terminating in a leading end and a trailing end half terminating in a trailing end. The anchor is coupled to the trailing end half of the length of the suture. The capsule is attached to the leading end of the suture and has a through-bore extending longitudinally through the capsule. The clasp is attached to the trailing end of the suture, the clasp attachable to the implantable support.

Abstract: A surgical suture includes a shaft having a leading end, a trailing end, and an outer surface extending between the leading and trailing ends. The surgical suture includes a plurality of flexible protrusions extending from the shaft, and a lumen extending between the leading and trailing ends of the shaft. The shaft includes a plurality of openings formed in the outer surface thereof that are in communication with the lumen. The shaft includes a first axial opening at the leading end thereof in communication with the lumen and a second axial opening at the trailing end thereof in communication with the lumen. A flowable material may be disposed in the lumen. After the surgical suture is implanted, the flowable material is adapted to pass from the lumen and through the plurality of openings in the outer surface of the shaft for contacting tissue surrounding the suture.

Abstract: In embodiments of the invention, a manufacturing process produces and an. Article produced has a self-retaining suture wherein a force is used to squeeze the suture causing retainers to form out of material from the suture body. In an embodiment of the invention, fins are formed between the retainers and the suture body, wherein said fins support the retainers. In another embodiment, retainer stops are provided in order to prevent the retainer from settling back in the body of the suture.

Abstract: The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point. Adjustable anchor assemblies, as well as anchor delivery systems, are also provided.

Abstract: A method for occluding an anatomical structure (such as a vessel or duct) having a lumen comprises: introducing percutaneously into the body of the patient a delivery device; advancing the delivery device through an extraluminal space within the patient's body to an occlusion site outside the lumen of an anatomical structure; deploying a pair of longitudinally-extending clamping jaws from the delivery device; and occluding the anatomical structure with the clamping jaws. The advance of the delivery device and the deployment of the clamping jaws is guided by near-real-time imaging of a target region of a body of a patient, the target region including the occlusion site on the anatomical structure. The delivery device is guided to the occlusion site outside the lumen of the anatomical structure, and the structure is occluded with the deployed clamping jaws engaging the exterior of the structure.

Abstract: A double or triple zip-tied anastomosis surgery method is provided. The method includes circumferentially fastening a first and a second zip-tie around a tubular organ or a connecting region between two tubular organs, with the first and second zip-ties beside each other; dissecting the tubular organ or the connecting region at a space between the first and second zip-ties, forming a first tubular portion with a first zip-tied end and a second tubular portion with a second zip-tied end; resecting a target segment from the second tubular portion, and centrally fastened the resected end; then rejoining the first and the second tubular portions together using a circular stapler, with staples encircling the first zip-tied end and the centrally fastened resected end; and cutting and removing tissues and zip-tie encircled by the staples to recreate a tubular pathway, with a smooth interface between the two tubular portions.

Abstract: Medical devices are manufactured from fine grained materials, processed from of a variety of metals and alloys, such as stainless steel, cobalt-chromium and nickel-titanium alloys. A fine grained metal or alloy is formed from a specimen rapidly heated to its recrystallization temperature, and then subjected to high temperature, multi-axial deformation, for example, by heavy cross-forging or swaging. The deformed specimen may be cooled and reheated to a second recrystallization temperature. The metal or alloy in the specimen is then allowed to recrystallize, such that the grain size is controlled by quenching the specimen to room temperature. A desired medical device is then configured from the fine grained material. Decreasing the average grain size of a substrate material and increasing the number of grains across a thickness of a strut or similar component of the medical device increases the strength of the device and imparts other beneficial properties into the device.