Abstract: A multi-instrument access device includes a base positionable within a percutaneous opening formed in a body. Ports are positioned on the base for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having steerable distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

Abstract: Methods and systems are disclosed for stimulating contents of the carotid sheath using an intravascular pulse generator and lead. The lead carries an energy delivery device such as an electrode, which is anchor within the portion of the internal jugular vein that is disposed within the carotid sheath. The energy delivery device is energized to transvenously direct energy to target contents of the carotid sheath external to the internal jugular vein. Such target contents may include nervous system elements associated with the carotid sinus baroreceptors, the carotid sinus nerve and associated nerve branches, and or the vagus nerve and associated nerve branches. The system may be used to control blood pressure and/or to lower heart rate and may be suitable for treatment of hypertension, heart failure, or other conditions.

Abstract: A system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: A surgical access system for use in minimally invasive procedures such as single port or laparoscopic surgery. The system has a sealed base positionable in an incision formed in a body wall and at least two access tubes extending through the base. Each access tube includes a rigid tube having a fixed pre-formed shape including a bend in its distal section. The rigid tubes are restrained against pivotable movement relative to the base, but can be axially rotated and longitudinally repositioned relative to the base. A deflectable tubes extends from the distal end of each rigid tube. Each deflectable tube has a lumen for passage of a medical instrument, as well as a proximal actuator which engages a pullwire to deflect the tube when the user manipulates the instrument's handle.

Abstract: A system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable using pivotable frame members to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: Methods and systems are disclosed for stimulating contents of the carotid sheath using an intravascular pulse generator and lead. The lead carries an energy delivery device such as an electrode, which is anchor within the portion of the internal jugular vein that is disposed within the carotid sheath. The energy delivery device is energized to transvenously direct energy to target contents of the carotid sheath external to the internal jugular vein. Such target contents may include nervous system elements associated with the carotid sinus baroreceptors, the carotid sinus nerve and associated nerve branches, and or the vagus nerve and associated nerve branches. The system may be used to control blood pressure and/or to lower heart rate and may be suitable for treatment of hypertension, heart failure, or other conditions.

Abstract: A multi-instrument access device includes a base positionable within an opening (e.g. an incision or puncture) formed in a body wall and a dome-shaped seal on the base and positioned such that it is disposed outside the body wall during use. A plurality of instrument ports extend proximally from the seal for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having pre-curved distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

Abstract: A system for minimally invasive medical procedures includes an elongate tubular access cannula comprising an elongate tubular member having a rigid proximal portion and an articulating portion. The tubular member has a first branch and a tubular bifurcation extending from the first branch, allowing simultaneous use of multiple instruments. A dissector suitable for use with the access cannula, or other access devices, for implantation of gastric bands or for other procedures includes a pre-curved distal portion having a dissection element such as a monopolar RF conductor and/or a dissection balloon, as well as a snare. In one method, the dissector is advanced around the posterior side of the stomach to form a tunnel in the connective tissue, and the snare is then extended from the dissector to engage a portion of the band and withdraw it through the tunnel.

Abstract: A device for treating GERD includes a pair of sections. Each section includes a proximal end portion with an arcuate interior opening, a distal end portion with an arcuate interior opening, an exterior plate portion, and a tapered body portion extending from the proximal end portion to the distal end portion. The pair of sections surround the esophagus at the gastro-esophageal junction thereof and to be secured together to form a tubular housing with a proximal orifice, a distal orifice smaller than the proximal orifice, and a plate adjacent the distal orifice. A portion of the housing adjacent the distal orifice is configured to elastically deform to constrict the esophagus and serve the function of the LES when a force is applied to the plate by the fundus. The proximal end portion of each mating section includes a flange portion configured to be attached to a body cavity wall.

Abstract: Satiation devices for controlling obesity and methods of implanting same are configured to create a small satiation pouch in the proximal portion of the stomach with a narrow passage leading into the lower portion of the stomach. The small satiation pouch is configured to collect a small amount of masticated food from the esophagus and the narrow passage delays emptying of the food from the satiation pouch into the larger part of the stomach, thereby causing a feeling of fullness.

Abstract: In a method for sealing an incision in an interior body wall such as a gastrotomy opening in a stomach, a closure device is positioned within the incision. The closure device includes a seal and an anchor coupled to the seal. The seal is positioned in sealing contact against a first surface of the body wall, and the anchor is positioned against the second surface of the body wall such that a portion of the closure device is positioned. The closure device seals the incision while healing takes place. Once the incision is significantly healed, the closure device bioerodes.

Abstract: An intestinal implant includes a proximal anchor self-expandable from a radially compressed position to a radially expandable position for engagement with a wall of the intestinal lumen and a flexible sleeve coupled to the anchor. The sleeve is implanted with the anchor downstream from the pylorus and the sleeve extending further downstream through the intestinal lumen.

Abstract: An artificial intervertebral disc and disc nucleus are described herein having chambers and dampening members. The dampening members may be within or outside of the main body of the device. The chambers may be filled with a suitable liquid, gas, or both, and separated by valves to regulate flow of fluid between chambers, within a dampening member, between the main body and dampening member, or all of the above. Chambers may be filled with responsive hydrogels, EPAM, or other suitable materials, and the device may have activation plates or members, a strain gauge, a pressure sensor, or other means for detecting changes in the materials and/or triggering desired changes in the materials in order to mimic the behavior of a healthy native disc or disc nucleus. A control system may be in communication with the device for receiving feedback and delivering stimuli to initiate desired changes in the fluids or other materials.

Abstract: A system for performing minimally invasive medical procedures through a natural orifice includes an elongate support advanceable in a flexible state through a natural orifice and through an incision in a body organ into a body cavity. The elongate support is convertible to a rigid state within the body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port into a body cavity includes an expandable frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: In a system and method for performing a treatment within a body cavity, an elongate cannula is provided having one or more distally positioned expandable elements. An incision is formed in body tissue to gain access to a body cavity. A distal portion of the cannula is extended through the opening and into the body cavity. The expandable element is expanded within the body cavity. During expansion, a portion of the expandable contacts tissue or structures within the body cavity, such that the expansion causes the distal portion of the cannula to deflect generally away from the tissue or structures.

Abstract: Embodiments of surgical access cannulas and access systems for use in gaining access to a body cavity of a patient via a natural orifice are disclosed. A distal end of an access cannula is advanced through a natural orifice into a hollow organ. Instruments passed through the cannula are used to form an incision in the wall of the hollow organ. The access cannula is anchored in the incision with its distal opening giving access to a body cavity outside the hollow organ. Surgical instruments are passed through the access cannula and used to perform procedures in the body cavity.

Abstract: The balloon portion of a balloon catheter for implanting a stent structure is at least initially retained laterally to a guide wire by passing the guide wire axially along the balloon inside the stent structure but not through the interior of the balloon or any permanent guide wire lumen at the location of the balloon. The initially deflated balloon may be folded laterally into a plurality of folds, and the guide wire may pass between the folds or outside the folds as desired. Guide wire lumens may be provided distally and/or proximally of the balloon. An elastic sleeve may be provided around the balloon to help keep the balloon folded prior to inflation and to help refold the balloon during and after deflation. If an elastic sleeve is provided, the guide wire may pass along the balloon inside the sleeve.

Abstract: A cannula and method provide manually manipulable orientation of a dissection probe carried eccentricity on the cannula for rotational and translational positioning relative to the field of view of an endoscope at a distal end of the cannula. Rotation of the cannula at fixed axial position relative to the endoscope, and rotational and translational positioning of the dissection probe relative to the distal end of the cannula provide wide-area access within the surgical site for bluntly dissecting connective tissue surrounding a vessel of interest being harvested.

Abstract: An apparatus and method for temporarily implanting an intraluminal stent in a body lumen and its subsequent removal. A stent is formed from a thin sheet that has been wound around itself into a generally cylindrical roll. The stent has a deployed configuration with a deployed diameter generally the size of the lumen diameter. The stent has a delivery configuration, formed by winding the stent more tightly than the deployed configuration, with the delivery diameter smaller than the deployed diameter in order to allow low profile delivery into the body lumen. The stent will transform from the delivery configuration to the deployed configuration when exposed to body heat. The stent can be deployed by an intraluminal delivery catheter that secures the stent in its delivery configuration during intraluminal delivery of the stent. The stent can be removed from the body lumen via a removal catheter that coils the stent into a sheath at the end of the removal catheter.