Abstract: A design for a suture for use in suture appositioning techniques, and a method for use are disclosed. In one embodiment the suture may comprise a hollow length having a wall forming a lumen, which may serve as a conduit through which fluid may be pumped and discharged through a plurality of perforations in the wall. In another embodiment the suture may comprise a plurality of suture members connected by a connecting member. In one embodiment of a method disclosed, a suture having a hollow length having a wall forming a lumen, with a plurality of perforations in the wall, may be placed in a stitching procedure to apposition tissues, and a fluid such as an adhesive, adhesive activating agent or drug may be pumped through the lumen and discharged out the perforations for various beneficial effects.

Abstract: A surgical device for applying a bandage onto tissue is disclosed. The surgical device has an actuator and contains one or more releasable bandages and an adhesive. Actuation of the actuator releases the adhesive, saturates the bandage with the adhesive, and releases the bandage onto tissue. The actuator can be squeezed, moved linearly, or rotated to dispense the adhesive onto the bandage and release the saturated bandage. The adhesive can be stored in an ampoule, or a sealed chamber. Actuation of the surgical device breaks the ampoule and/or seal and releases the adhesive for use. In addition to the adhesive, additional fluids or additives can be mixed with the adhesive or stored in separate chambers of the ampoule or surgical device. These additives can include drugs, image enhancing agents, necrosing agents, sclerosing agents, and the like.

Abstract: A health care assessment system and associated methods are provided for providing increased access to individuals for assessing whether a need exists for health care and then also facilitating an individual's access to health care as needed. Embodiments of the system include a health care assessement system for receiving input from a patient and generating an output reflecting an indivdual's risk of one or more disease states. The health care assessment system is further capable of providing resources for health care and visual tools for collecting patient history.

Abstract: The method disclosed may be used following a prostatectomy, and may comprise inserting an instrument into the bladder lumen through incisions in the abdomen and bladder wall; using an end effector thereon to urge the bladder wall to the pelvic floor and align the openings of the bladder and urethra, and drive an anchor through the bladder wall into the pelvic floor, thereby connecting a balloon harness to the pelvic floor; inflating a balloon within the harness, which holds the bladder wall surrounding the bladder opening against the pelvic floor; maintaining the balloon in place and draining the bladder via a catheter during the time required for the tissues to effectively knit; and then deflating the balloon, disconnecting the harness, and withdrawing the instrument. The instrument may comprise one or more tubes that support an end effector comprising a positioner, an anchor driver, a harness, a balloon and a catheter.

Abstract: A material comprising a matrix or a buttress is impregnated with an adhesive initiator and is used with a surgical stapling device and an adhesive. The tissue and material are stapled together, and a knife in the surgical stapling device cuts the tissue and the material. The adhesive is applied across the cut and sets up or polymerizes to seals the cut when the adhesive contacts the adhesive initiator. The surgical stapling device can place the staples in a linear, arcuate, or circular array, and can anastomose luminal tissue. The methods of use can include stapling luminal tissue end to end, stapling two portions of material onto ether side of tissue, and stapling two portions of tissue onto a portion of material. Additionally, a portion of adhesive filed material can be stapled onto one side of portion of tissue and the adhesive initiator impregnated material can be stapled onto the other.

Abstract: Disclosed is an instrument for use in a procedure to effect anastomosis of a patient's bladder and urethra following a prostatectomy having a tube assembly, and an end effector assembly operably supported by the tube assembly. The end effector assembly includes a positioner assembly and an anchor driver assembly in operable mechanical communication with first and second rods of the tube assembly, so as to be actuable by movement of the first and the second rods with respect to a spine member.

Abstract: A multiple use adhesive dispenser facilitates precise, extended dispensing for a surgical procedure by sequentially positioning an ampoule containing a flowable material, such as a polymerizable monomer compound such as a cyanoacrylate adhesive. In one version particularly suited to an open surgical procedure, the ampoules are affixed to a tape substrate that is unreeled from an internal storage reel and transported proximate to an ampoule gripping mechanism with an underlying tape substrate peeled away and internally stored as each ampoule is positioned for dispensing. Actuating an ampoule advancement handle positions the next ampoule and squeezing a movable handle toward a fixed handle effects dispensing. Another version has an elongate shaft that internally augers each ampoule in succession into a pair of spaced jaws that are pinched together by actuating rods to dispense adhesive.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: A surgical access device includes a base having two or more ports or apertures that provide for the insertion of surgical instruments. The multi-port insert may be used with a laparoscopic access device. The multi-port insert may also include one or more instrument supports that are attached to the base to fix the position of one or more surgical instruments inserted through the multi-port insert.

Abstract: A first expression of apparatus for keeping clean a medical viewing scope's distal scope end includes a tube, an annular sheath, and a handpiece. The tube has a proximal end fluidly connectable to irrigation fluid and has a distal end fluidly connected to the handpiece. The sheath is surroundingly attachable to the scope and includes a lumen between the sheath's inside and outside diameters. The lumen has a substantially constant cross-sectional flow area which is substantially equal in area to the tube's cross-sectional flow area. The handpiece is in fluid communication with the proximal lumen end. The distal scope end is positioned proximate the attached sheath's distal lumen end. A second expression of the apparatus has the lumen with a substantially crescent shape without any limitation on its cross-sectional flow area. In an alternate embodiment, the lumen substantially continuously varies in cross-sectional flow area and/or irrigation flow path direction.

Abstract: Disclosed is an instrument and method for use in a procedure to effect anastomosis of a patient's bladder and urethra following a prostatectomy. The instrument comprises a tube assembly, and an end effector assembly operably supported thereby, where the end effector assembly includes a positioner assembly and an anchor driver assembly in operable mechanical communication with a handle, for use in performing anastomotic procedures.

Abstract: Methods and devices are provided for marking tissue to be subsequently located for removal from a body or for other examination. In general, a marker is provided that can be delivered adjacent to tissue desirable for marking. The marker can coil adjacent to the desired tissue. The marker can remain disposed in the body in its coiled position and be subsequently palpably identified and/or visually identified to locate the desired tissue.

Abstract: Methods and devices are provided for marking tissue to be subsequently located for removal from a body or for other examination. In general, a marker is provided that can be delivered to a target tissue. In one embodiment, the marker can include a solution having a visual marking component and a palpably identifiable tactile marking component. The marker can remain in the body and be subsequently visually and/or palpably identified to locate the target tissue.

Abstract: Methods and devices are provided for marking tissue to be subsequently located for removal from a body or for other examination. In general, a marker is provided that can be delivered through a tissue wall proximate to tissue desirable for marking. The marker can be movable between a non-deployed or unexpanded position, in which the marker is configured to be delivered through a relatively small diameter passageway, to an expanded, balloon-like position in which the marker is configured to engage opposed sides of a tissue wall proximate to the desired tissue. The marker can remain disposed in the body in its expanded position and be subsequently palpably identified and/or visually identified to locate the desired tissue.

Abstract: A surgical kit can be used to manipulate tissue within the body of a patient to create a working space within the body to allow a surgeon to easily access and work within the body using various surgical instruments. A surgical kit can include an implant comprised of a magnetic material which can be engaged with tissue within the body. The kit can further include a surgical instrument having a magnet which can be used to manipulate the implant and tissue engaged therewith. A surgical kit can include an anchor and a hanger configured to engage tissue at different locations within the body and a connection member engaged with the anchor and the hanger such that the connection member can be pulled to move the anchor toward the hanger. A surgical instrument which utilizes a vacuum provided to one or more movable members can also be used to manipulate tissue.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having an extendable and retractable petal operably connected to a tube, and an anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver pin operably connected to a tube.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having an extendable and retractable petal operably connected to a tube, an anchor driver, and an anchor releasably held by the anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver pin operably connected to a tube.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having a positioner arm that is extendable and retractable by rotation of a tube, and an anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver arm that is extendable and retractable by rotation of a tube.

Abstract: A material comprising a matrix or a buttress is impregnated with an adhesive initiator and is used with a surgical stapling device and an adhesive. The tissue and material are stapled together, and a knife in the surgical stapling device cuts the tissue and the material. The adhesive is applied across the cut and sets up or polymerizes to seals the cut when the adhesive contacts the adhesive initiator. The surgical stapling device can place the staples in a linear, arcuate, or circular array, and can anastomose luminal tissue. The methods of use can include stapling luminal tissue end to end, stapling two portions of material onto ether side of tissue, and stapling two portions of tissue onto a portion of material. Additionally, a portion of adhesive filed material can be stapled onto one side of portion of tissue and the adhesive initiator impregnated material can be stapled onto the other.