Abstract: Methods for treating hydrocephalus using a shunt, the shunt having one or more CSF intake openings in a distal portion, a valve disposed in a proximal portion of the shunt, and a lumen extending between the one or more CSF intake openings and the valve, the method comprises deploying the shunt in a body of a patient so that the distal portion of the shunt is at least partially disposed within a CP angle cistern, a body of the shunt is at least partially disposed within an IPS of the patient, and the proximal portion of the shunt is at least partially disposed within or proximate to a JV of the patient, wherein, after deployment of the shunt, CSF flows from the CP angle cistern to the JV via the shunt lumen at a flow rate in a range of 5 ml per hour to 15 ml per hour.

Abstract: There is disclosed a porous emboli deflector for preventing cerebral emboli while maintaining cerebral blood flow during an endovascular or open surgical procedure. The device prevents the entrance of emboli of a size able to cause stroke (such as greater than 100 microns) from entering either the right or left common carotid arteries, and/or the right or left vertebral arteries by deflecting emboli downstream of these vessels. The device can be placed prior to any manipulation of the heart or aorta allowing maximal protection of the brain during the index procedure. The deflector has a low profile within the aorta which allows sheaths, catheters, or wires used in the index procedure to pass. Also disclosed are methods for insertion and removal of the deflector.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.

Abstract: The surgical instrument includes a distal tool, an elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via distal and proximal bendable motion members. Actuation means extends between said distal and proximal members whereby any deflection of said control handle with respect to said elongated instrument shaft causes a corresponding bending of said distal motion member for control of said working member. The proximal bendable member comprises a ball and socket assembly supported between the handle and instrument shaft and constructed and arranged for three dimensional motion.

Abstract: A mechanism for feeding a fastener including a housing having a longitudinal axis and at least one fastener within the housing. The fastener has a crown and at least two legs extending therefrom. The fastener is disposed within the housing in a first plane parallel to the longitudinal axis. The mechanism includes an elongated actuator disposed within the housing. The actuator has a shaft substantially parallel to the longitudinal axis of the mechanism and rigidly spaced from the fastener in a second plane. The actuator has at least one radially extending advancer disposed along a length thereof, and a mechanism for rotating the actuator so that the advancer engages the fastener.

Abstract: Surgical instruments and techniques are provided for creating a pneumostoma through the chest wall into the lung of a patient. The pneumostomy instruments and techniques may be used to create a pneumostoma which allows gases to escape from the lung through the chest wall and thereby treat chronic obstructive pulmonary disease.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.

Abstract: A fastener applying device including a staple housing having a proximal end attached to a handle, a distal end, and a longitudinal axis therebetween. There is at least one fastener within the housing. The device also includes an anvil movable within the staple housing. The anvil has a proximal position and a distal position, wherein when in the distal position a distal end of the anvil extends distal to the distal end of the staple housing by a distance. The device also includes an adjustment nut connecting the staple housing to the handle. Rotation of the adjustment nut changes the distance.

Abstract: A fastener applying device including a staple housing having a proximal end attached to a handle, a distal end, and a longitudinal axis therebetween. There is at least one fastener within the housing. The device also includes an anvil movable within the staple housing. The anvil has a proximal position and a distal position, wherein when in the distal position a distal end of the anvil extends distal to the distal end of the staple housing by a distance. The device also includes an adjustment nut connecting the staple housing to the handle. Rotation of the adjustment nut changes the distance.

Abstract: A pneumostoma management system which includes a pneumostoma management device and a cover. The pneumostoma management device maintains the patency of a pneumostoma while controlling the flow of material through the pneumostoma. The pneumostoma management device includes a hydrophobic filter and/or a one-way filter. The cover serves to protect the pneumostoma management device and/or provide a cosmetic skin to make the pneumostoma management device more acceptable to the patient and thereby encourage patient compliance with a pneumostoma treatment regimen.

Abstract: A pneumostoma management system for maintaining the patency of a pneumostoma while controlling the flow of material through the pneumostoma. The pneumostoma management system includes a two-part pneumostoma management device and associated insertion and removal tools. The pneumostoma management device includes a pneumostoma vent and a chest mount for positioning and securing the vent into a pneumostoma. The pneumostoma vent includes a hydrophobic filter and/or a one-way valve.

Abstract: A surgical fastener applying device having a handle with a trigger pivotably attached thereto and movable within a trigger plane. The trigger has a bottom portion extending from the handle and a top portion disposed within a housing of the handle. The device has a staple housing with a proximal end attached to the handle, a distal end extending therefrom and a longitudinal axis therebetween. The housing has a firing bar disposed within, and the trigger is coupled to the firing bar. The device has a link member with a first end pivotably attached to the top portion of trigger, the link member has a second end comprising a slidable pin. The pin engages a three dimensional cam path disposed within the housing. The link member follows distal and proximal movement of the top portion of the trigger, and the pin slides perpendicular to the trigger plane to follow the three dimensional cam path.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.

Abstract: A flexible pneumostoma management device maintains the patency of a pneumostoma while controlling the flow of material through the pneumostoma. The pneumostoma management device includes a pneumostoma vent having a tube which enters the pneumostoma to allow gases to escape the lung, a flange and a filter/valve to control flow of materials through the tube. The flange is a thin flexible patch which conforms and attaches to the chest of the patient. The flange secures the tube in position in the pneumostoma. The device has features to control secretions from the pneumostoma. The secretion management features include, ridges, pores, absorbent materials, and combinations thereof.

Abstract: An instrument for reconfiguring stomach tissue includes a sealing member that seals a section of a tissue manipulator from contact with bodily fluids. The tissue manipulator includes a first portion that is configured for releasable coupling to an actuating member and a second portion configured to receive an implant to be deployed within the patient. The tissue manipulator also includes a rectangular member and a cavity for receiving a coupler of the actuating member. The tissue manipulator has a first member with tissue penetrating elements and a second member with engaging elements configured to deflect the tissue penetrating elements upon relative movement of the first and second members. The actuating member includes a tissue penetrating element support positioned to limit bending of the tissue manipulator. The instrument includes an actuating mechanism that is configured to move at least one of the first and second members of the tissue manipulator.

Abstract: The surgical instrument includes a distal tool, a rigid or flexible elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via distal and proximal bendable motion members. Actuation means extends between said distal and proximal member to control bending. A manually rotatable member rotates the instrument shaft and working member relative to the control handle. A locking member is supported from the control handle and has locked and unlocked states; in the unlocked state enabling control of the distal work member from the proximal control handle via the bendable members; and in the locked state, holding the bendable members in a pre-selected relative fixed position.

Abstract: A medical instrument for engaging tissue includes a flexible shaft, a tissue piercing coil at a distal portion of the shaft, and a tissue stabilizer positioned over the shaft and biased in a distal direction such that as the tissue piercing coil enters tissue, the tissue stabilizer is urged against a surface of the tissue. A medical instrument for reconfiguring tissue includes a flexible shaft defining a lumen housing actuating controls, and a distal actuating assembly with a sealing portion configured to substantially seal the shaft lumen from contact with bodily fluids. A cartridge assembly includes first and second members configured for releasable attachment to a medical instrument, and a holder configured to receive the first and second members and to be released from the first and second members upon action of the first and second members attaching to the medical instrument.

Abstract: Surgical instruments and techniques are provided for creating a pneumostoma through the chest wall into the lung of a patient. The pneumostomy instruments and techniques may be used to create a pneumostoma which allows gases to escape from the lung through the chest wall and thereby treat chronic obstructive pulmonary disease.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing having a proximal position and a distal position. When the anvil is in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop, wherein at least one fasteners is placed around the anvil when the anvil is in distal position. And a distal end of the anvil extends distal to the distal end of the staple housing. The applier further includes a first means for moving the anvil distally during a deployment of the at least one fastener, and a second means for moving the anvil distally during the deployment of the at least one fastener, wherein the second means is independent of the first means.

Abstract: A fastener applying device for surgically attaching tissue together. The device includes a staple housing having a proximal end attached to a handle, a distal end and a longitudinal axis therebetween. There is at least one fastener within the housing. The device includes an anvil movable within the staple housing. The anvil has a proximal position and a distal position, wherein when in the distal position a distal end of the anvil extends distal to the distal end of the staple housing by a distance. The device further includes an adjustment nut connecting the staple housing to the handle, wherein rotation of the adjustment nut changes the distance.