Abstract: Methods, compositions, and devices for treating a vascular aneurysm, including an abdominal aortic aneurysm, are disclosed. In particular, the various embodiments relate to a method of treating an abdominal aortic aneurysm by increasing the mechanical stiffness of an aortic segment adjacent to the abdominal aortic aneurysm in a subject. The mechanical stiffness of the adjacent aortic segment may be increased, for example, by applying a surgical adhesive or intravascular stent. Such treatment reduces stress on the aortic wall and limits further growth of the abdominal aortic aneurysm.

Abstract: Medical device delivery system including a catheter, handle, lock line handle, and lock line. The catheter includes a proximal end portion and a distal end portion. The handle is coupled to the proximal end portion of the catheter. The lock line handle is releasably coupled to the handle and actuatable between a lock position and an unlock position. The lock line includes a first end portion fixedly coupled to the lock line handle, a second end portion releasably coupled to the lock line handle, and an intermediate portion configured to be releasably coupled to the medical implant disposed proximate the distal end portion of the catheter. Actuating the lock line handle from the lock position toward the unlock position increases tension on the lock line, and actuating the lock line handle from the unlock position toward the lock position decreases tension on the lock line.

Abstract: Balloon catheters for delivery of prosthetic hear valves is provided. The balloon catheters are configured to deploy a prosthetic heart valve through inflation. The balloon catheters are further configured with one or more retention bumpers to reduce or prevent migration of the prosthetic heart valve during delivery. Balloon catheters described herein are configured with substantially incompressible retention bumpers that promote longitudinal inflation fluid flow.

Abstract: Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

Abstract: A gastrointestinal tissue approximation clip system for approximating tissue defects, which includes an applicator that is sized to travel through an instrument channel of an endoscope; first and second tissue approximation clips that are transported to first and second locations of a tissue defect respectively by the applicator to approximate the tissue defect; first and second sutures attached to the first and second tissue approximation clips respectively; a clip approximation means for approximating the first and second tissue approximation clips. The clip approximation means and the first and second tissue approximation clips are sized to travel through the instrument channel, and the first and second tissue approximation clips are adapted to be detachably coupled to the applicator.

Abstract: A surgical clip pack includes a frame configured to engage a portion of a surgical access device. The frame includes a storage compartment and an annulus defining a lumen that has a diameter at least as large as a diameter of an opening of the surgical access device. A receptacle is disposed within the storage compartment and is configured to house a surgical fastener.

Abstract: A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Abstract: A surgical access device includes a tube and a housing coupled to the tube. The housing is configured for passage of a surgical instrument therethrough. The housing includes first and second chambers where the second chamber surrounds the first chamber. A seal is disposed in the first chamber. A port extends from the housing and is in fluid communication with the second chamber. A nozzle is defined between a distal portion of an outer wall of the first chamber and a wall of the housing. The nozzle is configured to direct fluid towards the second chamber.

Abstract: A medical device is disclosed, which is capable of preventing a maintenance treatment element imparting energy to biological tissue from being displaced from a treatment target site and a treatment method performed on a heart failure patient. A medical device is disclosed, which includes a shaft portion, an expandable and contractible expansion body provided on a distal side of the shaft portion, and a maintenance treatment element disposed in the expansion body and imparting energy to biological tissue. The expansion body includes a concave portion recessed in a direction intersecting with an axial direction of the shaft portion. The maintenance treatment element is disposed in the concave portion.

Abstract: A guidewire holding device comprises a sheath including a lumen, a holder disposed at a distal end of the sheath and configured to be switchable between holding a guidewire and releasing the guidewire, a treatment tool inserted in the lumen to perform an intended treatment, and a wire connected to the treatment tool and configured to move the treatment tool between a first configuration and a second configuration. In the first configuration, the treatment tool is contained insider the lumen, and, in the second configuration, the treatment tool is protruded from the distal end of the sheath.

Abstract: A hollow rod developable actuator tool including a first link comprising an outer cylinder, a second link comprising a first tool member pivotably connected to the first link at a first joint mounted in a first cavity in the wall of the outer cylinder, a third link comprising a second tool member pivotably connected to the first tool member at a second link, and a fourth link comprising an inner cylinder to which the second tool member is also pivotably connected at a third link mounted in a second cavity in the wall of the inner cylinder. When the inner cylinder of the fourth link is rotated in relation to the outer cylinder of the first link the actuator tool transitions from a first state where the tool is closed to a second state where the tool is open.

Abstract: A surgical instrument is provided having an actuator mechanism with an integrated extension element. The surgical instrument comprises a handle assembly, an elongate shaft, and an end effector. The end effector can comprise a jaw assembly having atraumatic pads positioned thereon to reduce force on grasped tissue. An actuator is movable within the elongate shaft to actuate jaws of the jaw assembly responsive to movement of a movable handle of the handle assembly. The actuator can have an integrated extension element that allows the actuator to translate within the elongate shaft upon application of a relatively low force and translate and extend upon application of a relatively higher force to the actuator to limit the force applied by the jaw assembly. The actuator is also able to utilize force stored with the integrated extension element to provide a dynamic amount of force used to grasp the tissue in scenarios where the tissue volume decreases while in the jaws.

Abstract: Extra-urethral implants and methods of use are disclosed. Implants can treat disorders or diseases of the prostate by, for example, enlarging the lumen of the prostatic urethra.

Abstract: A medical device that includes a handle, a shaft extending distally from the handle, an end effector extending distally from the shaft, a first actuator movably coupled to the handle, and a second actuator movably coupled to the handle. The first actuator is configured to (1) articulate the shaft in response to translating the first actuator in a first direction relative to the handle and the second actuator, and (2) actuate the end effector in response to translating the first actuator in a second direction relative to the handle and the second actuator. The second actuator is configured to (1) articulate the shaft in response to translating the second actuator in the first direction relative to the handle and the first actuator, and (2) actuate the end effector in response to translating the second actuator in the second direction relative to the handle and the first actuator.

Abstract: The present invention relates to a medical apparatus for closing an aperture, an incision, a puncture, a passage through tissue and/or a communication with a blood vessel or other body lumen (short: aperture) of a tissue of a patient, the medical apparatus comprising a closing device holder, for releasably receiving one or more closing devices; and a retracting unit to come into contact with opposite sides of the aperture and for retracting them and/or for spreading the aperture causing it to change its shape into a slit or a slit-like or a more slit-like aperture or to spread or to augment the dimension or diameter of the aperture in at least one or in exactly one dimension of the aperture.

Abstract: A medical device includes a shaft, an end effector at a distal end of the shaft, the end effector having a first jaw that pivots relative to a second jaw about a pivot axis, a control mechanism engaging a surface of the first jaw, such that when the control mechanism translates relative to the pivot axis from a first state to a second state, the surface of the first jaw moves relative to the control mechanism and pivot about the pivot axis. The medical device further includes an actuator extending through the shaft and coupled to the control mechanism, where translation of the actuator translates the control mechanism from the first state to the second state.

Abstract: A method for resetting a stapling apparatus includes providing an apparatus with a cam member in a fired position. A circuit of the apparatus is then changed from a first polarity state to a second polarity state. A motor of the apparatus is then activated to rotate the cam member from a fired position back to a home position while the circuit is in the second polarity state.

Abstract: Methods and systems for closing an opening or defect in tissue, closing a lumen or tubular structure, cinching or remodeling a cavity or repairing a valve preferably utilizing a purse string or elastic device. The preferred devices and methods are directed toward catheter-based percutaneous, transvascular techniques used to facilitate placement of the devices within lumens, such as blood vessels, or on or within the heart to perform structural defect repair, such as valvular or ventricular remodeling. In some methods, the catheter is positioned within the right ventricle, wherein the myocardial wall or left ventricle may be accessed through the septal wall to position a device configured to permit reshaping of the ventricle. The device may include a line or a plurality of anchors interconnected by a line. In one arrangement, the line is a coiled member.

Abstract: A robotic surgical tool includes an elongate shaft, an end effector arranged at a distal end of the shaft and including a first jaw providing a first jaw extension and a second jaw providing a second jaw extension, and an articulable wrist that interposes the end effector and the distal end, the wrist including an articulation joint rotatable about a first pivot axis, and first and second pulleys rotatably mounted to the articulation joint at a second pivot axis perpendicular to the first pivot axis, the first pulley interposing the first jaw extension and a first joint portion of the articulation joint, and the second pulley interposing the second jaw extension and a second joint portion of the articulation joint. Joining the first and second joint portions secures the first and second pulleys within the wrist.

Abstract: A method for implanting a medical lead. The method includes advancing a tunneling tool posteriorly proximate the caudal end of the sternum toward a first location. The tunneling tool is advanced superiorly underneath the sternum through the anterior mediastinum from the first location to a second location cranial to the first location. A guidewire is advanced from the first location to the second location. A medical lead is slid along at least a portion of the guidewire, the medical lead at least substantially spanning the distance between the first location and the second location.