Abstract: A procedure wherein an elongate, at least partially flexible tie member is partially wound about tissues to be closed at a surgical site. Opposite ends of the flexible tie element are entrained by a twisting instrument which has a distal end juxtaposed to the surgical site. The twisting instrument extends out of the patient so that a proximal end of the instrument is manipulable by a surgeon. The surgeon rotates the instrument about a longitudinal axis, thereby twisting the tie member multiple turns about itself. Where the tie member is a wire, the twisting effectively locks the tie member at the surgical site. The tie member may then be severed by a cutters so that the tissues are closed.

Abstract: A guitar case has a casing frame including a plurality of inflatable bladders for defining a compartment for receiving a guitar and for resiliently supporting the guitar placed in the compartment. The bladders when inflated or expanded substantially surround and grip the guitar in the compartment. The bladders are releasably connected to one another along their peripheries, by a zipper or by VELCRO.TM. type loop and hook fasteners. The two halves of the inflatable guitar case may be completely separable. In that case, at least one of the bladders is provided with a shelf for supporting the guitar and with a stand element for supporting the bladder and the guitar in an upright orientation. The guitar case may be a stand-alone case and in that event is provided with a handle or hand grip for facilitating manual transport of the case and the guitar therein. Alternatively, the above-described guitar case may function as a liner to be inserted in a conventional guitar case with rigid or semirigid panels.

Abstract: A method for performing a coronary artery bypass comprises utilizes a thoracoscope and a tubular bypass member. The method includes the step of disposing the thoracoscope in the pericardium of a patient so that the distal end of the thoracoscope projects unto the intrapericardial space of the patient. The bypass member is inserted into the intrapericardial space, and, under direct observation via the thoracoscope, the bypass member is attached to the aorta and a coronary artery of the patient so that blood flows from the aorta through the bypass member and into the coronary artery.

Abstract: A catheterization device comprises a catheter, a hollow hypodermic needle longitudinally traversing the catheter, and a pressure detector and indicator attached to the needle at a proximal end thereof for sensing pressures inside a patient upon insertion of a distal tip of the needle into the patient and for qualitatively indicating the sensed pressure. The pressure detector and indicator includes an at least partially transparent housing, a fluid in the housing communicating with a lumen of the needle, and a movable indicator element such as a styrofoam sphere disposed in the fluid in the housing.

Abstract: A method for obtaining access to a hollow organ of a patient comprises the steps of (i) providing a tubular member, (ii) pressing an end of the tubular member against a wall of the hollow organ, and (iii) removing a section of the organ wall surrounded by the tubular member, while maintaining the tubular member in engagement with the organ wall. The tubular member has a flange at the end which glued to the organ wall prior to the removal removal of the organ wall section. To remove the organ wall section an elongate instrument is inserted through the tubular member and operated to excise the organ wall section. An incision is made by cutting the organ wall with a laser or a blade. In either event, the excising instrument may be turned about an axis to form a closed circuit incision. The removal excised organ wall section is further implemented by securing the excised section of the organ wall to a distal end of the instrument, e.g., via suction or a hook element.

Abstract: In a method in aortic surgery where the aorta of a patient is cut longitudinally to insert a prosthetic vessel or graft to bypass or remove an aneurysm, a plurality of closure elements or plugs are inserted into respective arterial tributaries, and particularly into their openings in the aortic wall, to stop blood backflow from the tributaries, thereby stemming blood loss during the surgery. The closure elements are provided with catch elements such as screw threads or shoulders for prventing inadvertant removal of the plugs from the tributaries. A recess or other element is provided at one end of the closure elements for receiving the operative head of a screwdriver or other tool to facilitate insertion of the closure elements into the branching blood vessels.

Abstract: An endovascular bypass graft includes a tubular member, a first expandable mesh stent attached to one end of the tubular member, and a second expandable mesh stent attached to an opposite end of the tubular member. The second stent is provided with a plurality of fenestrations. The graft is inserted into a principal blood vessel such as the aorta and positioned in the vessel so that the fenestrations are aligned with junctions with ancillary blood vessels. The graft is attached to the principal blood vessel so that the fenestrations remain aligned with the respective junctions, thereby allowing blood flow between the principal vessel and the auxiliary vessels through the respective junctions upon completion of the bypass operation.

Abstract: A method for obtaining a biopsy uses an instrument assembly which includes an elongate tubular member having a distal end portion defining a specimen-receiving chamber, the instrument assembly being provided at a distal end with a cutting blade extending in a plane oriented substantially transversely with respect to the tubular member. The distal end portion of the tubular member is inserted into organic tissues of a patient so that some of the tissues enter the chamber. Upon sufficient insertion of the distal end portion of the tubular member into the organic tissues of the patient, the blade is moved in the transverse plane to thereby sever the tissues in the chamber from tissues outside the chamber. Upon shifting of the blade to sever the tissues in the specimen-receiving chamber, the distal end portion of the tubular member is removed from the patient, together with the severed tissue sample.

Abstract: A laparoscopic instrument comprises an elongate shaft, an applicator component on the shaft for applying a biologically active composition to a tissue surface inside a patient during a laparoscopic procedure, and a fiber optic laser beam transmission guide extending along the shaft from a proximal end to a distal end of the shaft. A laser source is operatively connected to the fiber optic guide at the proximal end of the shaft for generating a laser beam for transmission through the guide upon application of the biologically active composition to the tissue surface during the laparoscopic procedure. The applicator component includes, at the distal end of the shaft, a roller or a flexible cup-shaped receptacle which stores a predetermined amount of the biologically active composition and which deforms in response to a pressing of the shaft, to deposit the biologically active composition onto the tissue surface.

Abstract: In a method for performing a vascular repair operation a tubular endovascular prosthesis member made of a nontoxic biocompatible material is inserted in a collapsed configuration into a blood vessel through an incision therein. Upon insertion, the tubular prosthesis member is expanded to a cylindrical configuration and attached along its upstream and downstream edges to the vessel wall. Where the attachment is implemented via a laser, an optical fiber is inserted into the blood vessel via an angioscopic instrument having a balloon with a mouth attached about a distal end of the angioscopic insertion member so that a distal tip of the insertion member is disposed inside the balloon. The balloon is made of a material transparent to optical radiation, as well as to the wavelength of the laser beam, whereby visualization of the arterial or venous wall and the bonding of the tubular prosthesis member thereto may be implemented through the balloon.

Abstract: A surgical sterilization method utilizes an elongate operating instrument assembly having a distal end portion which is inserted into a patient's Fallopian tube. The instrument assembly is operated to destroy cells along an inner surface of the Fallopian tube essentially throughout a segment thereof, while maintaining an outer surface of the Fallopian tube intact. Upon operation of the instrument assembly to destroy cells along the inner surface of the Fallopian tube segment, the tube is collapsed along the treated segment, thereby adhering the inner surface of the Fallopian tube to itself to seal the tube.

Abstract: Techniques for effectively sterilizing catheters, particularly long-dwelling intravenous catheters, are disclosed. The techniques include the transmission and dispersion of ultraviolet or infrared radiation, the heating or cooling of a catheter distal end portion, and the transmission of electrical current along the catheter and through the catheter lumen or organic tissues in which the catheter resides.

Abstract: A surgical instrument assembly comprises an elongate member provided at a distal end with a clamping member having a pair of opposed jaws. Each of the jaws includes an elongate substantially linear arm. The instrument assembly additionally comprises an actuator mehanism mounted to the elongate member and operatively connected to the jaws for alternately opening and closing the jaws, as well as at least one balloon element attached to the jaws so as to form a cushion upon inflation of the balloon element. An inflation device is operatively connected to the balloon element for inflating the balloon from a collapsed insertion configuration to an expanded use configuration.

Abstract: In a method for use in cleaning a flexible endoscope, an elongate cleaning member having an embedded optical fiber, an electrical conductor, and/or a heat conductor is inserted into a biopsy channel of the endoscope. Sterilizing radiation of a predetermined wavelength is transmitted along the optical fiber from a proximal end of the elongate cleaning member towards a distal end thereof. The radiation is dispersed to at least partially sterilize the biopsy channel. Heat energy is conducted along the heat conductor to raise or lower the temperature of the biopsy channel for a predetermined period to effectuate a sterilizing action. Electrical current may also be transmitted along the biopsy channel wall by virtue of the electrical conductor. The method also comprises the step of ejecting a sterilizing fluid from the elongate cleaning member into the biopsy channel.

Abstract: A surgical instrument assembly comprises an elongate member provided at a distal end with a clamping member having a pair of opposed jaws and at least one balloon element attached to the jaws so as to form a cushion upon inflation of the balloon element. An inflation device is operatively connected to the balloon element for inflating the balloon from a collapsed insertion configuration to an expanded use configuration. A closure device is associated with and at least partially coextensive with the elongate member in a longitudinal direction for closing the clamping member about an object such as a section of colon.

Abstract: A laparoscopic instrument comprises a receptacle for storing a predetermined amount of a biologically active composition, a mechanical ejector operatively connected to the receptacle for ejecting the predetermined amount of the biologically active composition into a patient's abdomen, and an actuator operatively connected to the ejector for enabling an actuation of the ejector to eject the predetermined amount of the biologically active composition into the patient's abdomen. The laparoscopic instrument includes an elongate hollow shaft.

Abstract: An endovascular bypass graft includes a tubular member, a first expandable mesh stent attached to one end of the tubular member, and a second expandable mesh stent attached to an opposite end of the tubular member. The second stent is provided with a plurality of fenestrations. The graft is inserted into a principal blood vessel such as the aorta and positioned in the vessel so that the fenestrations are aligned with junctions with ancillary blood vessels. The graft is attached to the principal blood vessel so that the fenestrations remain aligned with the respective junctions, thereby allowing blood flow between the principal vessel and the auxiliary vessels through the respective junctions upon completion of the bypass operation.