Abstract: Methods and devices are provided for providing access through tissue to a surgical site. In one embodiment, a surgical access device can include a hollow tubular member and a modular seal member. The modular seal member can be configured to radially span a lumen of the tubular member and can be removably and replaceably matable to a portion of the tubular member. The access device can also include a plurality of access ports, each of which can be configured to mate with the modular seal member at a respective desired location.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems and ingestible pills. In one embodiment, a method of producing satiety comprising the steps of accessing a gastrointestinal tract of a patient and implanting an intraintestinal therapeutic substance eluting implant. The implant is capable of eluting a satiety inducing substance selected from at least one of a nutrient, a specific satiety inducing bio-active substance, pancreatic polypeptides, free fatty acids, cholecystokinin, amino acids, glutamine, lipids, linoleic acid, or a combination thereof, from the implant into the gastrointestinal tract.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: Methods and devices reroute chyme to induce intestinal brake in order to improve the effectiveness of bariatric surgical procedures and to improve comorbidity resolution. A bowel is manipulated to provide a shortened path for chyme to travel to the ileum. These methods and devices of rerouting chyme to induce intestinal brake may include one or more of a surgical procedure, an implanted device, or a combination of an implant with an improved surgical procedure.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

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 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: Methods and devices reroute chyme to induce intestinal brake in order to improve the effectiveness of bariatric surgical procedures and to improve comorbidity resolution. A bowel is manipulated to provide a shortened path for chyme to travel to the ileum. These methods and devices of rerouting chyme to induce intestinal brake may comprise one or more of a surgical procedure, an implanted device, or a combination of an implant with an improved surgical procedure.

Abstract: Methods described herein involve introducing a nasogastric tube into a patient, connecting the nasogastric tube with a reservoir, anchoring the nasogastric tube with the nasal cavity, and introducing a substance into the reservoir through the nasogastric tube.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices may be accomplished via stabilized implantable systems and ingestible pills. In one aspect, a method of inducing satiety includes implanting an implant within a lumen of a gastrointestinal tract and retaining a portion of chyme that flows by the implant within a body of the implant. The method further involves re-releasing the retained chyme from the implant into the gastrointestinal tract at a predetermined rate slower than a rate caused by natural peristalsis.

Abstract: Devices and methods for modifying stomach volume include the formation of intragastric slots for wrapping one or more portions of the fundus therethrough with minimal interference with nerves and vasculature flow. Intragastric space occupying devices expand with environmental changes brought about by natural conditions inherent to the digestive cycle such as with changes in pH. Extragastric volume occupying balloons are placed into folded stomach sections. The balloons are fluidly coupled to external gastric filling devices. In yet another set of embodiments, methods and devices provide adjustable gastric volume reduction fundal wraps. In one embodiment, a device is placed in the fundus for Nissen fundoplication and permits postoperative adjustment to reach desired weight loss. Intragastric and extragastric balloons are optionally incorporated.

Abstract: L-cells may be introduced in the gastrointestinal tract. L-cells are used in the digestive process to produce a more efficient and lasting means of regulating feelings of satiation in a patient. Desired metabolic effects may be achieved by manipulating L-cells via delivery sites, frequency of delivery, or type of biological substance delivered.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems and ingestible pills. In one embodiment, a method of producing satiety comprising the steps of accessing a gastrointestinal tract of a patient and implanting an intraintestinal therapeutic substance eluting implant. The implant is capable of eluting a satiety inducing substance selected from at least one of a nutrient, a specific satiety inducing bio-active substance, pancreatic polypeptides, free fatty acids, cholecystokinin, amino acids, glutamine, lipids, linoleic acid, or a combination thereof, from the implant into the gastrointestinal tract.

Abstract: Devices and methods for modifying stomach volume include the formation of intragastric slots for wrapping one or more portions of the fundus therethrough with minimal interference with nerves and vasculature flow. Intragastric space occupying devices expand with environmental changes brought about by natural conditions inherent to the digestive cycle such as with changes in pH. Extragastric volume occupying balloons are placed into folded stomach sections. The balloons are fluidly coupled to external gastric filling devices. In yet another set of embodiments, methods and devices provide adjustable gastric volume reduction fundal wraps. In one embodiment, a device is placed in the fundus for Nissen fundoplication and permits postoperative adjustment to reach desired weight loss. Intragastric and extragastric balloons are optionally incorporated.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: Various methods and devices are provided for accessing a body cavity. In one embodiment, a surgical access device is provided and includes an elongate member having a proximal support member configured to rest against an external tissue surface, a flexible elongate central portion extending distally from the proximal support member and configured to extend through tissue, and an inflatable distal portion coupled to a distal end of the central portion. The distal portion is movable between an initial configuration, in which the distal portion is configured to be passed through an incision in tissue, and an inflated configuration in which the distal portion is expanded such that the central portion forms a working channel through the tissue for access to a body cavity. The distal portion can include an opening such that gas delivered to the distal portion can flow through the opening to insufflate a body cavity.

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 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: Methods and devices are provided for providing access through tissue to a surgical site. In one embodiment, a surgical access device can include a hollow tubular member and a modular seal member. The modular seal member can be configured to radially span a lumen of the tubular member and can be removably and replaceably matable to a portion of the tubular member. The access device can also include a plurality of access ports, each of which can be configured to mate with the modular seal member at a respective desired location.

Abstract: Various methods and devices are provided for accessing a body cavity. In one embodiment, a surgical access device is provided and includes an elongate member having a proximal support member configured to rest against an external tissue surface, a flexible elongate central portion extending distally from the proximal support member and configured to extend through tissue, and an inflatable distal portion coupled to a distal end of the central portion. The distal portion is movable between an initial configuration, in which the distal portion is configured to be passed through an incision in tissue, and an inflated configuration in which the distal portion is expanded such that the central portion forms a working channel through the tissue for access to a body cavity. The distal portion can include an opening such that gas delivered to the distal portion can flow through the opening to insufflate a body cavity.