Abstract: Devices, systems, methods and kits are provided for endoscopically accessing a body cavity and providing a directed pathway toward a target tissue within the cavity. The directed pathway is provided by a multi-catheter guiding system which is positioned in a desired configuration, generally directed toward the target tissue. Interventional devices may then be passed through the guiding system to the target tissue. Depending on the location of the target tissue and the desired angle of approach, the guiding system may be required to maintain one or more curves in one or more planes to properly direct the interventional devices. The multi-catheter guiding system of the present invention comprises an outer guiding catheter and a coaxially positioned inner guiding catheter, each of which independently form curvatures so that together the curves properly direct the interventional device.

Abstract: Methods, devices, tools and assemblies for treating a patient to effect weight loss. One method embodiment involves passing a device including an expandable member in a collapsed configuration and a buoyancy member through an opening in the skin of a patient and into the abdominal cavity of the patient, and anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity. Devices including at least one expandable member and at least one buoyancy member are provided.

Abstract: Apparatus and methods for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.

Abstract: Implantable devices, instruments, kits and methods for treatment of obesity. One or more devices can be implanted adjacent to or in contact with the stomach to occupy a space to prevent the stomach from expanding into that space as food is taken into the stomach. Alternatively, one or more devices may be implanted and expanded to displace at least a portion of the wall of the stomach to decrease the internal volume of the stomach that is available to receive food. Devices may be anchored to one or more internal structures at one or more locations without piercing through the wall of the stomach. Devices can be implanted using minimally invasive methods, such as percutaneous or laparoscopic methods. Delivery instruments are also provided. An intra-gastric sizing device is provided to facilitate implantation of an extra-gastric device in some method embodiments.

Abstract: Methods, devices, tools, instruments and systems for treating a patient to induce weight loss. In one method embodiment, a device, including an expandable member in a collapsed configuration, is passed through an opening in the skin of the patient, and into the abdominal cavity of the patient. At least a portion of the expandable member is anchored relative to at least one structure in the abdominal cavity, without piercing the stomach. The expandable member is expanded to an expanded configuration in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach.

Abstract: Apparatus is provided, including a tube (22) that is configured to pass into a patient's vagina (26) and to penetrate vaginal tissue (24) until a distal tip (36) of the tube is outside of a uterine artery (28) of the patient, but in a vicinity of a portion (38) of the uterine artery that supplies a uterine fibroid (30). A balloon (40), disposed at the distal tip, is inflated to cause local squeezing of the portion of the uterine artery to an extent sufficient to occlude the uterine artery. Other embodiments are also described.

Abstract: Medical devices, such as endoprostheses, and methods of making the devices are described. In one embodiment, a medical device having a body of interconnected bands and connectors forming an elongated tubular structure having an inner luminal wall surface, an outer abluminal wall surface and a side wall surface, and defining a central lumen or passageway, wherein said inner luminal wall surface and side wall surface of the bands and connectors form transverse passageways through the elongated tubular structure is described. One or more wall surfaces of the tubular structure can bear a coating whose selected regions define at least one depression. The coating can further include at least one biologically active substance.

Abstract: Methods, devices, tools and assemblies for treating a patient to effect weight loss. One method embodiment involves passing a device including an expandable member in a collapsed configuration and a buoyancy member through an opening in the skin of a patient and into the abdominal cavity of the patient, and anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity. Devices including at least one expandable member and at least one buoyancy member are provided.

Abstract: Artificial valves for use as a venous valve or a heart valve are disclosed. The valve includes a frame including a platform and a valve material coupled to the frame. The valve material is a plurality of filaments or a flap. The valve material is coupled to the frame such that in response to a force in a first direction, e.g. blood flow, the valve material extends in the direct of the force to allow blood to flow past the valve material. In absence of the force in the first direction, the valve material rests against the platform to block blood flow in a direction opposite the first direction.

Abstract: Methods, devices, tools, instruments and systems for treating a patient to induce weight loss. In one method embodiment, a device, including an expandable member in a collapsed configuration, is passed through an opening in the skin of the patient, and into the abdominal cavity of the patient. At least a portion of the expandable member is anchored relative to at least one structure in the abdominal cavity, without piercing the stomach. The expandable member is expanded to an expanded configuration in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach.

Abstract: The present invention provides a novel dry powder inhalation system suitable for transpulmonary administration. The dry powder inhalation system of the invention characterized by using a combination of: (1) a vessel housing a freeze-dried composition that contains a single dose of an active ingredient, and has: (i) a non-powder cake-like form, (ii) a disintegration index of 0.015 or more, and (iii) a property of becoming fine particles having a mean particle diameter of 10 microns or less or a fine particle fraction of 10% or more upon receipt of an air impact having an air speed of at least 1 m/sec and an air flow rate of at least 17 ml/sec; and (2) a device comprising means capable of applying said air impact to the freeze-dried composition in said vessel, and means for discharging the powder-form freeze-dried composition that has been made into fine particles.

Abstract: A delivery device (20, 22) for and a method of delivering a substance to the nasal airway (1) of a subject, in particular the posterior region of the nasal airway, the delivery device comprising: a closure unit for causing the closure of the oropharyngeal velum of the subject; and a delivery unit for delivering a gas flow entraining a substance to one of the nostrils of the subject at such a driving pressure as to flow around the posterior margin of the nasal septum and out of the other nostril of the subject, wherein the delivery unit comprises a nosepiece (30, 40, 58, 82, 102, 132) which includes an outlet through which the gas flow is in use delivered to the one nostril and a sealing member for sealing the one nostril to the outlet such as in use to prevent the escape of the gas flow through the one nostril.

Abstract: A vaso-occlusive device includes a microcoil formed into a minimum energy state secondary configuration comprising a plurality of curved segments, each defining a discrete axis, whereby the device, in its minimum energy state configuration, defines multiple axes. Confinement of the device within an aneurysm causes it to assume a three-dimensional configuration with a higher energy state than the minimum energy state. Because the minimum energy state configuration of the device is larger (in at least one dimension) than the aneurysm, the deployed device is constrained by its contact with the walls of the aneurysm from returning to its minimum energy state configuration. The engagement of the device with the aneurysm wall minimizes shifting or tumbling due to blood flow.

Abstract: A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to flex relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. Tissue suturing and suture securing instruments are provided each having a sufficiently flexible shaft locatable through the accessory tube.

Abstract: The present invention provides a clipping device having a coil sheath inserted into an insertion tube in a back/forth movable way to allow it to be inserted into a body cavity, an operation wire inserted into the coil sheath in a back/forth movable way, and a clip directly connected to a distal end of the operation wire to allow it to clip a living tissue.

Abstract: A delivery device for a bifurcated stent-graft includes a first catheter portion with a first tip and a second catheter portion with a second tip. The first and second tips each include a generally curved and tapered outer surface and complementary surfaces that face each other. The first and second tips together form a generally continuous substantially smooth shaped outer surface, for example a bullet-shaped combined tip. An outer sleeve is disposed around the first catheter portion and the second catheter portion such that at least a portion of the first tip and a portion of the second tip extend distally beyond a distal end of the outer sleeve. An inner sleeve maintains the stent-graft in a compressed configuration during delivery to the target site. The delivery device is tracked over two guidewires to the target location with the tips acting as a unit.

Abstract: A delivery device includes an outer sidewall and an inner sidewall extending therein. An outer surface of the inner sidewall defines a plurality of longitudinally extending grooves, each of which interlock with a corresponding inward protruding member of a plurality of longitudinally extending inward protruding members defined by an inner surface of the outer sidewall. A longitudinally extending lumen of the device, which may accommodate delivery of an implantable medical device, is defined, at least in part, by the inner surface of the inner sidewall. A slitting zone of the device, for example, provided by one of the sidewalls extending less than 360 degrees about a longitudinal axis of the device, enables removal of the delivery device from around the delivered device.

Abstract: Methods and devices for partitioning or plicating a region of a hollow body organ are described herein. These methods and devices relate generally to medical apparatus and methods and more particularly to devices and methods for affecting a change in the function of a hollow body organ, particularly a stomach, intestine or gastrointestinal tract. These changes can include reducing the volume capacity of the hollow body organ, disrupting or altering the normal function of the organ, functionally excluding certain sections of the organ either by affixing adjacent tissue or excising certain regions, or affecting or correcting the response of the organ to naturally occurring stimuli, such as ingestion.

Abstract: Embodiments of the invention include a medical instrument with a sealing device. In embodiments, the medical instrument is an endoscopic device having a seal between an elongate shaft member and/or on a portion of a handle to, for example, prevent flow communication between a lumen of the elongate member and the external environment.

Abstract: A catheter (10) having an internal tube (13) and an external tube (14) which at least sectionally encloses the internal tube (13). The external tube (14) is connected to a balloon (16) having an endoprosthesis section (18) which positions an intraluminal endoprosthesis (20). The catheter (10) has stiffening means (31, 33, 34, 35) located in the area of at least one end of the endoprosthesis section (18) in its longitudinal direction on the internal tube (13). Also disclosed is a system comprising an intraluminal endoprosthesis (20) and a catheter (10) used for introducing an intraluminal endoprosthesis (20), preferably a stent, into a body cavity.