Abstract: An instrument and method for performing some medical procedure in an interior portion of the body of a living being from outside the body of the being via a small percutaneous incision or puncture. The instrument includes a proximal portion, a distal portion, and a working head coupling to the proximal portion to be operated thereby. The proximal portion is arranged to be held outside the body of the being by the user of the instrument. The distal portion comprises a tip having a tissue engagement surface which is sufficiently blunt so that it does not present a hazard to internally located tissue, yet which will form at least a portion of the percutaneous incision or puncture. The distal portion of the instrument is arranged to be extended through the skin and underlying tissue, which is internally supported, e.g.

Abstract: A device for administering a liquid into the body of a person through a natural orifice, e.g., the anus or vagina, while the person is seated on a toilet. The device comprises a base unit, an extendable tube having a distal end, and a vessel containing the liquid for introduction into person. The base unit comprises a saddle arranged for disposition under the toilet seat and configured to be disposed between the buttocks of the person when he/she is seated the seat. A positionable guide tube extends through a portion of the saddle from an entrance point adjacent the front of the toilet to an opening located at a position adjacent the natural orifice, e.g., anus or vagina, when the person is seated. The extendable tube has a distal end portion arranged to be inserted by the person into the guide tube and through the opening, and the guide tube is arranged to be slid with respect to the saddle, so that the distal end portion of the extendable tube is directed upward and enters the natural orifice.

Abstract: Apparatus and methods of use performing some medical procedure, e.g., positioning tissue, in the body of a being. The apparatus having a proximal portion and a distal portion, with the distal portion including a piercing end for forming a small percutaneous incision or puncture to enable the distal portion be inserted into the being's body to a desired internal position without the use of a trocar or other introducing device. The distal portion of the apparatus is elongated and has a longitudinal axis. An actuatable mechanism, e.g., a pair of moveable jaws, is located at the distal portion and is arranged to project outward laterally of the longitudinal axis for engagement with tissue located at the operative site to perform some operation, e.g., clamping. The actuatable mechanism is actuated by the proximal portion of the apparatus.

Abstract: A system, a closure, and method of use for determining the position of a blood vessel via a percutaneous puncture and for sealing the percutaneous puncture in the blood vessel. The system includes an introducer sheath and associated positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device enables the introducer sheath to be positioned at a desired position within the vessel. The deployment instrument includes a tubular carrier storing the closure. The carrier has a distally located free end to be extended via an introducer through the puncture and its associated tract. The closure comprises a radiopaque rigid anchor, a compressed collagen plug, and a thin filament connecting the two in a pulley-like arrangement. The carrier ejects the anchor through the introducer and puncture and then draws it against the free end of the introducer.

Abstract: A device for administering a liquid into the bowel of a person. The device comprises a rigid conduit, a manually actuatable pump, and a reservoir holding the liquid. The conduit is of a general J-shape having an elongated straight proximal section and a curved distal section terminating in a tip having an aperture therein. The elongated proximal section is sufficiently long that when the person is seated on a toilet with the proximal section located between the person's legs the tip is located at the person's anus, so that he/she can readily insert the tip into the anus by manually manipulating the proximal section of the conduit. The pump is coupled to the proximal section of the conduit and is arranged to be squeezed by the person to pump the liquid from the reservoir through the conduit and out the aperture into the person's bowel.

Abstract: A system and method of use for reflecting tissue located within the body of a living being. The system comprises at least one clip, a clip introducer instrument, a positioning member in the form of a tension cable assembly, and a clip removal instrument. The introducer instrument is arranged for delivering the clip through a small percutaneous incision or puncture to the situs of the tissue. The clip has a pair of jaws defining a mouth therebetween and are moveable between a open and a closed position. The jaws are biased to the closed position by an biasing member which is actuatable via the same or another percutaneous incision or puncture so that at least a portion of the tissue is trapped within the clip's mouth when it closes.

Abstract: A system, a closure, and method of sealing a percutaneous puncture in an artery. The system includes a conventional introducer sheath, a hemostatic puncture closure, and an instrument for deploying the closure. The instrument includes a tubular carrier storing the closure. The carrier has a distally located free end to be extended through the puncture and its associated tract. The closure comprises a rigid anchor, a compressed collagen plug, and a thin filament connect the two in a pulley-like arrangement. The carrier is operated to eject the plug through the puncture and to then draw it against the free end of the introducer. The instrument and introducer are then withdrawn together to pull the anchor against the tissue contiguous with the puncture on the inside of the artery.

Abstract: Closure devices and methods of use for sealing a small, e.g., percutaneous, incisions or punctures. The closure device may take many forms an basically comprises a somewhat elongated plug having a deformable distal end portion including a free end to which a thin retraction filament is connected. The closure device is arranged to be introduced into the body of the being through the incision or puncture by an introducer so that the distal portion of the plug is located on one side of said tissue and its proximal portion is located on the other side of that tissue, with the filament extending through the incision or puncture. The filament is arranged to be grasped and pulled in the proximal direction to deform the distal portion of the plug so that it cannot pass back through the incision or puncture, whereupon the puncture or incision is sealed by the deformed distal portion of the plug.

Abstract: A method of destroying tissue such as a gall bladder located within the body of a living. A sclerosing agent is introduced into the body in a volume contiguous with the surface of the tissue to be destroyed. The sclerosing agent comprises a flowable material made up of a liquid carrier and a large plurality of abrasive particles, e.g., acicular particles of carborundum, silicon carbide, etc., Optionally, a symphysis agent, such as an antibiotic, may be introduced into the volume. Once the agent is introduced, it is caused to circulate therein whereupon its scrapes across the surface of the tissue to effect the sclerosing thereof.

Abstract: A catheter and method of use for engaging material within the body of a living being to accomplish a medical and/or surgical procedure, e.g., form and enlarging an opening in a restriction in a vessel, duct, or lumen formed by the material, or to destroy a stone or other hard body formed of the material. The catheter comprises an elongated body portion and a rotatable working head located at the distal end of the catheter. The catheter is positioned with the working head adjacent the material to be enlarged. The working head comprises at least two, non-sharp, impacting surfaces, each of differing aggressiveness of restriction opening action. The less aggressive of the impacting surfaces is brought into engagement with the material when the working head is rotated in one rotational direction. The more aggressive of the impacting surfaces is then rotated in the opposite rotational direction and brought into engagement with the material to complete the procedure.

Abstract: An instrument and methods of making and use for sealing a small, e.g., percutaneous, incisions or punctures. The instrument in the form of a tubular member having a plug therein. The tubular member includes a proximally located piston and a distally located portion having an open free end for introduction into the incision or puncture. The plug comprises a cord and a thin filament, with the cord being formed of a resorbable material and being folded in two to form an apex portion and a pair of wing portions extending therefrom. The filament is secured to the apex portion. The plug is located within the tubular member so that the apex portion is disposed adjacent the free end and with the wing portions and the filament extending toward the proximally located portion. The plug is then expelled partially from the tubular member so that the apex portion extends through the incision or puncture.

Abstract: A catheter and method of use for engaging material within the body of a living being to accomplish a medical and/or surgical procedure, e.g., from and enlarging an opening in a restriction in a vessel, duct, or lumen formed by the material, or to destroy a stone or other hard body formed of the material. The catheter comprises an elongated body portion and a rotatable working head located at the distal end of the catheter. The catheter is positioned with the working head adjacent the material to be enlarged. The working head comprises at least two, non-sharp, impacting surfaces, each of differing aggressiveness of restriction opening action. The less aggressive of the impacting surfaces is brought into engagement with the material when the working head is rotated in one rotational direction. The more aggressive of the impacting surfaces is then rotated in the opposite rotational direction and brought into engagement with the material to complete the procedure.

Abstract: A method and apparatus for sclerosing tissue located within an organ, e.g., the gall bladder, of a living being. The apparatus comprises a catheter having a rotatable working head at its distal end. The working head includes an extendable tissue engaging member. The catheter is introduced percutaneously through an introducer sleeve so that the working head is located within the organ. The extendable member is extended generally outward radially when the working head is rotated at a high rate of speed to cause its free end to repeatedly engage the tissue forming an inner surface of the organ to thereby mechanically scrape that tissue. A sclerosing agent, e.g., alcohol, may also be introduced into the organ to expedite the procedure.

Abstract: An instrument, a closure, and method of use for sealing an opening, e.g., a percutaneous incision or puncture, in a living being. The instrument includes a tubular carrier storing the closure. The carrier has a distally located free end to be extended through the opening. The closure comprises an anchoring portion, a sealing portion and a thin filament connected therebetween. The instrument is operated to eject the anchoring portion of the closure through the incision or puncture and to then draw that portion against the free end of the carrier. The instrument is then withdrawn to pull the anchoring portion of the closure against the tissue contiguous with the incision or puncture. Further withdrawing of the instrument draws the sealing portion of the closure out of the carrier, whereupon it moves with respect to the anchoring portion and into engagement with the tissue contiguous with the opening on the opposite side of the anchoring portion to seal it. Signals are produced to indicate proper operation.

Abstract: A device and method for sealing a puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being, e.g., a puncture or incision in an artery, in the gall bladder, in the liver, in the heart, etc. The device comprises plug means having a holding portion which is adapted to engage portions of the tissue adjacent the puncture or incision to hold the plug means in place and a sealing portion formed of a foam material and extending through the puncture or incision to engage the tissue contiguous therewith to seal the puncture or incision from the flow of body fluid therethrough. In the preferred embodiment, the closure or plug means is formed of a biodegradable material.

Abstract: A device for sealing an opening or puncture in the wall of a blood vessel, duct or other lumen of a living being. The device includes an elongated tubular body having an outlet at the distal end thereof and which is arranged to be inserted, such as percutaneously, through the puncture in the blood vessel so that the outlet is located within the vessel's interior. An expandible closure is disposed within the tubular body and is formed so as to be held in a compact configuration therein. The tubular body also includes ejecting means for forcing the closure out of the outlet into the interior of the blood vessel, whereupon the closure automatically expands to form an enlarged engagement surface. A retraction filament is secured to the closure for pulling it to the puncture after the tubular body has been withdrawn from the puncture so that the engagement surface of the closure means hemostatically engages the inner surface of the blood vessel contiguous with the puncture.

Abstract: A flexible, small diameter catheter for effecting the formation of a restriction in a vessel, duct or lumen in a living being and methods of using the catheter. The catheter contains a working head arranged for high speed movement with respect to a longitudinal axis of the catheter. The high speed movement of the working head causes the tissue of the vessel, duct or lumen to produce a restriction. In one aspect of the invention the restriction formation is expedited by the expulsion of a liquid and/or particles into the tissue wall adjacent the working head. In another aspect of the invention the working head includes abrasive means thereon for abrading or otherwise sclerosing the tissue of the vessel, duct or lumen adjacent the working head. A sclerosing liquid or a tissue swelling liquid or adhesive agent can also be introduced by the catheter into contact with the tissue of the vessel, duct or lumen to expedite the restriction forming process.

Abstract: An elongated catheter for pumping blood through at least a portion of a being's vascular system. The catheter is of sufficiently small diameter and flexiblility to enable it to be passed through the vascular system so that the distal end portion of the catheter is located within or adjacent the being' heart. A rotatable pump is located at the distal end of the catheter and is rotated by drive means in the catheter. The distal end portion of the catheter includes an inlet for blood to flow therein and an outlet for blood to flow thereout. The catheter is arranged so that blood is pumped by the catheter's pump through the heart and into the vascular system without requiring any pumping action of the heart.

Abstract: A catheter device for introduction into the body of a being to effect a procedure, e.g., lumen opening, therein. The catheter is an elongated member having a working head at its distal end and is sufficiently flexible and of small diameter to enable it to be located within the body of the being with the working head at the situs of the procedure. The catheter comprises an elongated drive wire extending through the catheter and motion transtator located at the distal end of the catheter. The wire is rotated at a high speed and the transtator translate that rotary motion into high speed reciprocation of the working head. In some embodiments, the motion transtator also causes the working head to be rotated at the same time it is reciprocated. In other embodiments, the working head is only reciprocated. In all cases, the motion of the working head is at a very high speed. The catheter also includes means to provide a fluid therethrough so that when the catheter is used to open a lumen, e.g.

Abstract: A device and method for sealing a puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being, e.g., a puncture or incision in an artery, in the gall bladder, in the liver, in the heart, etc. The device comprises plug means having a holding portion which is adapted to engage portions of the tissue adjacent the puncture or incision to hold the plug means in place and a sealing portion formed of a foam material and extending through the puncture or incision to engage the tissue contiguous therewith to seal the puncture or incision from the flow of body fluid therethrough. In the preferred embodiment, the closure or plug means is formed of a biodegradable material.