Abstract: The present invention is directed generically to a means for altering the ability of the mammalian body to absorb nutritive content from ingested foodstuffs, and more specifically to an apparatus and method of use for an endolumenal sleeve (referred to also as an “intragastrointestinal device” or “gastrointestinal device”) positioned in the mammalian gastrointestinal (GI) tract. A suitable endolumenal sleeve is comprised of an anchor element and an opening at a proximal end, an elongate lumen or hollow open-ended tube having a transverse dimension, and a distal orifice. Optionally, an exterior aspect of the elongate lumen may include additional modes of attachment to the tissues walls of the GI tract through the use of one or more means for promoting tissue in-growth.

Abstract: Methods and devices for partitioning hollow organs or cavities of the body are described. A tissue securement device having securement arms is positioned through portals formed in opposing tissue walls of an organ. The securement arms may be articulated to facilitate placement. Once positioned the securement arms may be activated to secure the opposing walls of the organ together. The securement arms may secure the walls together through the use of staples, t-tags, sutures, clamps, helical anchors, braided anchors or fastening devices or systems.

Abstract: A method of determining relative neuro-muscular response onset value thresholds for a plurality of spinal nerves, comprising: depolarizing a portion of the patient's cauda equina; and measuring the current intensity level at which a neuro-muscular response to the depolarization of the cauda equina is detected in each of the plurality of spinal nerves.

Abstract: An expandable tip cannula system, comprising: a hollow cannula shaft having a proximal end and a distal end; and an expandable tip mounted at the distal end of the hollow cannula shaft, the expandable tip comprising a plurality of generally-triangular shaped petals held together in a radially-inwardly tapered arrangement between adjacent petals, each petal comprising a nerve sensing electrode disposed therein.

Abstract: Methods for determining structural integrity of a bone within the spine of a patient, the bone having a first aspect and a second aspect, wherein the second aspect separated from the first aspect by a width and located adjacent to a spinal nerve. The methods involve (a) applying an electrical stimulus to the first aspect of the bone; (b) electrically monitoring a muscle myotome associated with the spinal nerve to detect if an onset neuro-muscular response occurs in response to the application of the electrical stimulus to the first aspect of the bone; (c) automatically increasing the magnitude of the electrical stimulus to until the onset neuro-muscular response is detected; and (d) communicating to a user via at least one of visual and audible means information representing the magnitude of the electrical stimulus which caused the onset neuro-muscular response.

Abstract: An expandable tip cannula system, comprising: a hollow cannula shaft having a proximal end and a distal end; and an expandable tip mounted at the distal end of the hollow cannula shaft, the expandable tip comprising a plurality of generally-triangular shaped petals held together in a radially-inwardly tapered arrangement between adjacent petals, each petal comprising a nerve sensing electrode disposed therein.

Abstract: Systems for determining structural integrity of a bone within the spine of a patient, the bone having a first aspect and a second aspect, wherein the second aspect separated from the first aspect by a width and located adjacent to a spinal nerve. A stimulator is configured to generate an electrical stimulus to be applied to the first aspect of the bone. A monitor is configured to electrically monitor a muscle myotome associated with the spinal nerve to detect if an onset neuro-muscular response occurs in response to the application of the electrical stimulus to the first aspect of the bone. An adjuster is configured to automatically increase the magnitude of the electrical stimulus to until the onset neuro-muscular response is detected. Lastly, a communicator is configured to communicate to a user via at least one of visual and audible means information representing the magnitude of the electrical stimulus which caused the onset neuro-muscular response.

Abstract: A method of determining relative neuro-muscular response onset value thresholds for a plurality of spinal nerves, comprising: depolarizing a portion of the patient's cauda equina; and measuring the current intensity level at which a neuro-muscular response to the depolarization of the cauda equina is detected in each of the plurality of spinal nerves.

Abstract: The preferred methods and devices described herein create more secure anchors in one or more segments of soft tissue that can be used as anchor points for other procedures. The device draws tissue into a fold, cuts an opening through the tissue fold and inserts an element alongside the outer walls of the tissue. In one aspect the element includes an anchor coupled to the element. The device then fastens the tissue walls and element together so that the element is sandwiched between the outer walls of the tissue and the anchor resides along the inner walls of the tissue.

Abstract: The preferred methods and devices described herein provide for creating adhesions between the tissue layers of folded soft tissue. The methods described can be accomplished with the use of an endoscope and once folds of tissue are formed and brought together using methods known in the art, the folds can be secured using a clamping system. This clamping system retains the tissue folds in a side by side relationship by exerting a clamping pressure against the folds. Over time the clamping pressure may initiate mucosal layer necrosis, deep tissue layer intermingling and tissue knitting.

Abstract: Disclosed are methods and devices for placing anchors into soft tissue such as the walls of the stomach. The anchoring device includes a tissue interface that is introduced in a collapsed configuration and which expands radially outward. The tissue interface includes a framework capable of distributing a load applied to the linkage element across the surface area of the tissue interface.

Abstract: A graphics processing device implementing a set of techniques for power management, preferably at both a subsystem level and a device level, and preferably including peak: power management, a system including a graphics processing device that implements such a set of techniques for power management, and the power management methods performed by such a device or system. In preferred embodiments, the device includes at least two subsystems and hardware mechanisms that automatically seek the lowest power state for the device that does not impact performance of the device or of a system that includes the device. Preferably, the device includes a control unit operable in any selected one of multiple power management modes, and system software can intervene to cause the control unit to operate in any of these modes. For example, the device can include a register interface to which an external processor can write control bits to select among the modes.

Abstract: A graphics processing device implementing a set of techniques for power management, preferably at both a subsystem level and a device level, and preferably including peak power management, a system including a graphics processing device that implements such a set of techniques for power management, and the power management methods performed by such a device or system. In preferred embodiments, the device includes at least two subsystems and hardware mechanisms that automatically seek the lowest power state for the device that does not impact performance of the device or of a system that includes the device. Preferably, the device includes a control unit operable in any selected one of multiple power management modes, and system software can intervene to cause the control unit to operate in any of these modes.

Abstract: A catheter and catheter system for eccentric remodeling and/or removal of atherosclerotic material of a blood vessel of a patient include an elongate flexible catheter body with a radially expandable structure. A plurality of electrodes or other electrosurgical energy delivery surfaces can radially engage atherosclerotic material when the structure expands. An atherosclerotic material detector near the distal end of the catheter body may measure circumferential atherosclerotic material distribution, and a power source selectively energizes the electrodes to eccentrically remodel the measured atherosclerotic material.

Abstract: Devices and methods for improved soft tissue securement are disclosed, and, in particular, to tissue anchoring elements and deployment thereof. Such tissue anchoring elements may comprise a linkage element and an array of spreading elements. Endoscopic devices and methods are disclosed for deploying multiple anchoring elements to multiple sites and manipulating at least some of the associated linkage elements to approximate selected sites. Applications of such endoscopic devices and methods may include endoluminal therapy such as gastroplasty, which may be used for the treatment of obesity and gastroesophageal disease. Such devices and methods may also include the attachment of a foreign body to a tissue mass. Further aspects of the invention include devices and methods for the modification of mechanical properties of the anchoring sites so as to decrease the likelihood that anchoring elements will pull out.

Abstract: A device and method for selectively engaging or penetrating a layer of a luminal organ wall where the luminal organ wall has a plurality of layers including an outermost layer and an innermost layer adjacent to the lumen of the organ. The device and method select one of the plurality of layers of the organ wall other than the innermost layer and deploy from within the lumen of the organ a tissue device through the innermost layer to a specific depth to engage or penetrate the selected one of the plurality of layers. The device and method may be employed to create luminal pouches or restrictive outlets. In a stomach organ, the device and methods may be employed to treat obesity by forming a gastric pouch with or without a restrictive outlet.

Abstract: A surgical device for expanding and viewing tissue is disclosed. The surgical device includes a handle, an insertion probe, and at least one window disposed within the insertion probe. The handle has a proximal end and a distal end, and the handle is sized and shaped to be held by a surgeon. The insertion probe has a proximal end, a distal end, and a longitudinal axis extending between the proximal end and the distal end. The proximal end of the insertion probe is removably attached to the distal end of the handle. The window extends along a length of the longitudinal axis, and has an opening that is sufficient in size to allow tissue to prolapse through the window and into the insertion probe.

Abstract: A graphics data processing system memory is allocatable by software between system memory and graphics framebuffer storage. The memory comprises two-port elements connected in parallel from the RAM port to a controller connected to a bus, and having serial output ports connected to output circuitry to map the storage to a display. Corresponding locations, relative to element origin, in all elements are addressed in parallel as an array. Three modes of memory transactions are all accomplished as array accesses. First, a processor reads/writes the system memory portion by a combination of parallel array access and transfers between controller and bus in successive bus cycles. Second, the controller executes atomic graphics operations on the framebuffer storage using successive array accesses; third, the processor can read/write a framebuffer pixel, by an array access of framebuffer storage with masking of unaddressed pixels. An interface arbitrates among requests for memory access.

Abstract: A method for drawing a convex geometric figure to framebuffer storage uses a plurality of update arrays which tile the framebuffer, each having a determined origin with respect to the framebuffer. Each update array has a multiplicity of concurrently updatable pixel storage sites, each specified by an offset from array origin. A figure is specified by a set of directed segments which form its perimeter. To access only those update arrays which tile the figure, the following methodology is used. A first update array which is known to be part of the figure is accessed. Tests are then performed to find whether the figure extends to arrays above or below the accessed array. If so, the array address is stored and marked for either or both extensions. In one embodiment, a test is performed for left extension, and the steps are repeated until no further left extension is found. Returning to the initial array, the steps are repeated for right extension to complete the horizontal subset.