Abstract: A system for tubular ligation is disclosed. The system may include an anchor designed to advance into a channel and engage the walls of the channel. The anchor may have mechanisms that allow it to securely attach to walls of the channel and pull the channel. The system may also include a body for placement adjacent to the channel to align the anchor with the channel. The anchor and body may be arranged so that subsequent retreat of the anchor toward the body pulls and inverts a portion of the channel. The system may also include an occlusion mechanism for placement about the inverted portion of the channel to seal the channel. The occlusion mechanism may be configured to bias between an open state for placement on the body, and a compressed state for sealing the channel. A method for tubular ligation is also disclosed.

Abstract: The present disclosure provides methods and systems for endoscopic visualization inside the human body and performing clinical procedures under endoscopic guidance. In one embodiment, an endoscopic cannula of the present disclosure may include an elongated body having a channel along which an endoscope can be advanced. The cannula further includes a tip about a distal end of the elongated body, which can be inflated from a substantially firm collapsed state to an expanded state. The cannula also includes a tube situated within the channel and attached at its distal end to a distal region of the tip to permit forward advancement of the tube along with the tip when the tip is expanded. The tube in combination with the channel form a working conduit for passing surgical instruments beyond the tip.

Abstract: A system for providing access across a site of obstruction is provided. The system may include a sleeve, having a distal portion that can move from an inverted position to an everted position. A balloon situated within the sleeve can be extended so as to evert sleeve. A pathway can extend across a juncture between the distal portion and the remaining portion of the sleeve so as to provide access across the site of obstruction. A method for providing access across the site of obstruction is also provided.

Abstract: A system is disclosed including a first expandable anchor and a second expandable anchors. The anchors may be delivered to opposing sides of a fascial opening and expanding to a predetermined size to secure the anchor at the site of delivery. A strap, designed to pull the anchors together, may extend from the first anchor to the second anchor. Upon deployment, a tension force may be exerted on the strap in order to pull the anchors toward one another and close the fascial opening. Methods and apparatus for closing the fascial opening are also disclosed.

Abstract: A system for tissue or organ removal is provided. The system has an outer bag having an exit end, and an inner bag situated within the outer bag and having an opening capable of receiving an organ or tissue. The inner bag may be sealed to the exit end of the outer bag about its opening. A fluid-tight space may be situated between the outer bag and the inner bag. The space may be designed to accommodate positive pressure which can act on the inner bag to cause the inner bag to evert and expel the organ or tissue. The system may also include an organ receiving component for receiving the organ as it is expelled. Methods for tissue or organ removal is also provided.

Abstract: A system is provided for fastening tissue. The system includes a fastening device designed to bias between an actuated state for delivering into tissue and a quiescent state for fastening the tissue. In an embodiment, the fastening device may include a plurality of coils between which tissue can be pinched or fastened. The system also includes a pathway along which the fastening device can be accommodated for subsequent delivery into the tissue, and an activation mechanism along the pathway to bias the fastening device into an activated state for delivery into the tissue. Fastening devices, and methods of fastening are also provided.

Abstract: A retractor and a surgical tool are posittioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a dissection cradle that is resiliently supported along an axis skewed relative to the axis of the cannula. The dissection cradle, in operation, is extended to cradle the target vessel, and the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate a side branch for exposure to a surgical tool. The retractor includes a hollow support and a spray nozzle disposed in the distal end of the retractor to form an irrigation system and lens washer that can be selectively positioned to direct the spray of irrigation fluid at a remote surgical site or at an endoscopic lens.

Abstract: An organ manipulator including at least one suction member or adhesive disk mounted to a joint providing freedom of movement of the at least one suction member or adhesive disk relative to its support. A method for retracting and maintaining an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) is provided.

Abstract: The present invention provides, in one embodiment, a vascular filter device for capturing dislodged blood clots within a vessel. The vascular filter device includes an expandable framework for securing the device within a vessel. The device also includes a pathway extending through the framework. The device further includes at least one filter in alignment with the pathway for capturing dislodged clots or emboli. In an embodiment, the filter can be given form by a material that can be easily eliminated in situ to permit reestablishment of the pathway.

Abstract: A system for removing undesirable material from vessels and from chambers within the heart is provided. The system includes a suction cannula for removing the undesirable material from a site of interest within a patient. A filter device may be provided for capturing the undesirable material and removing it from the fluid flow. The system also includes pump for generating the necessary suction force through the suction cannula to dislodge the undesirable material from the site of interest and for generating a sufficient driving force to direct the fluid flow downstream within the system. The system further includes a reinfusion cannula for introducing fluid removed from the site of interest back into a patient. A method for removing undesirable material from vessels and from heart chambers is also provided.

Abstract: A system for gaining access to an interventional site within vasculature through a vessel wall or other structure such as that of a medical device. An apparatus is provided to accomplish a sealed worksite as are sensor delivery systems including sealable sensor devices that are adapted to be placed at the interventional site.

Abstract: The present invention provides bariatric therapy systems. One system includes a gastrointestinal implant device and a delivery mechanism therefor. The device can include a sleeve for placement into a small intestine and to minimize absorption of nutrients by its walls. An anchoring mechanism coupled to a proximal end of the sleeve and designed to be secured within the stomach can be provided. A passageway extending through the anchoring mechanism and the sleeve can also be provided, along which food can be directed from the stomach to the small intestine. The delivery mechanism can include a housing for accommodating the device, and a deploying balloon situated within the housing and which can be actuated to direct the sleeve of the device from within the housing to the site of implantation. Methods for providing bariatric therapy are also provided by the present invention.

Abstract: Systems and methods for extraction of implanted articles are disclosed. According to aspects illustrated herein, there is provided a system for extraction of an implanted article that includes an elongated member, guide member disposed at a distal section of the elongated member and having a pathway in substantially parallel relationship to the elongated member, through which pathway an implanted article can be accommodated, and a cutting mechanism, situated between the distal section of the elongated member and the guide member, for severing a fibrous adhesion about the implanted article to allow the implanted article to be extracted.

Abstract: A surgical blower for providing a directed stream to clear a surgical site, that can be used in multiple different use modes. In one use mode, the surgical blower is handheld by a user during operation. In another mode, a distal end portion of the blower is fixed to a foot of a stabilizer instrument and the handle of the blower is handheld. In another mode, a distal end portion of the blower is fixed to a foot of a stabilizer instrument and the handle of the blower is fixed to a stationary object such as a sternal retractor. In another mode, the distal end of the blower is free and the handle of the blower is fixed to a stationary object. An apparatus including a blower and a stabilizer is provided. Methods of using the blower as well as the apparatus are also provided.

Abstract: Forming a proximal anastomosis on an aortic wall includes method and instrumentation and apparatus for forming an aortic puncture and inserting into the vessel through the puncture a fluid-impervious sealing element with a protruding retainer. An anastomosis of a graft vessel over the puncture is partially completed with the retainer of the sealing element protruding through the partial anastomosis. The retainer facilitates removal of the sealing element from the partial anastomosis prior to completion of the procedure.

Abstract: Surgical apparatus and method includes a cannula that houses an endoscope and supports a dilating element near a distal end of the cannula. The dilating element has a dimension which is greater than the diameter of the cannula for enlarging a surgical cavity in tissue as the cannula is advanced through tissue at a surgical site to provide working space adjacent a target vessel within which surgical instruments may be conveniently manipulated. The dilating element of oval sided shape permits surrounding tissue to be pushed away or otherwise displaced away from the target vessel atraumatically. A locking mechanism is disposed on the cannula, which accepts a succession of mating dilating elements of progressively larger dimensions for successive insertion and enlargement of a surgical cavity as required.

Abstract: Systems and methods for extraction of implanted articles are disclosed. According to aspects illustrated herein, there is provided a system for extraction of an implanted article that includes an elongated member and a guide member disposed at a distal section of the elongated member. The guide member may define a pathway through which an implanted article can be securely received. The device can further include a dissection mechanism, coupled to the elongated member and designed to be positioned about the implanted article, for dissecting a fibrous adhesion about the implanted article.

Abstract: A cannula and surgical methods include a tubular body, for housing an endoscope having a lighted, viewing end disposed near the distal end of the body that is selectively covered by a blunt, transparent, tissue-separating tip. Endoscopic viewing through the tip is enhanced by inner walls that taper to a cusp adjacent the blunt tip in order to reduce visual distortion. Alternatively, a removable or deflectable tip exposes a probe and endoscope to facilitate viewing and dissection of connective tissue and lateral vessels along the course of a blood vessel for subsequent harvesting or other treatment of the isolated blood vessel. The dissection probe includes a partial ring for passing along the vessel and past lateral branching vessels under visualization through the endoscope and the transparent tip. Surgical procedures including making an initial incision, above an artery or other vessel to establish an initial portion of an elongated working cavity of bluntly-dissected tissue.

Abstract: The present invention provides bariatric therapy systems. One system includes a gastrointestinal implant device and a delivery mechanism therefor. The device can include a sleeve for placement into a small intestine and to minimize absorption of nutrients by its walls. An anchoring mechanism coupled to a proximal end of the sleeve and designed to be secured within the stomach can be provided. A passageway extending through the anchoring mechanism and the sleeve can also be provided, along which food can be directed from the stomach to the small intestine. The delivery mechanism can include a housing for accommodating the device, and a deploying balloon situated within the housing and which can be actuated to direct the sleeve of the device from within the housing to the site of implantation. Methods for providing bariatric therapy are also provided by the present invention.

Abstract: A retractor and a surgical tool are positioned at the distal end of the cannula. A dissection cradle is located at the distal end of a distal portion of the retractor that is resiliently skewed relative to the cannula axis, and includes two substantially parallel, spaced legs with the retractor shaped in a loop therebetween. The procedure includes locating a vessel and side branch of interest and extending the retractor to retain the vessel in the dissection cradle to urge the vessel away from the axis of the cannula in order to isolate a side branch for exposure to the surgical tool.