Abstract: A pre-assembled chain of staples is provided that is suitable for use in bariatric surgery. The pre-assembled chain of staples includes a plurality of staples, each of the staples having two spaced apart legs and a crown connector which joins the two legs to each other at upper ends thereof and spaces the two legs a predetermined fixed distance apart from each other at their upper ends. The chain of staples also includes rings for joining adjacent staples together, which rings can be separate from the staples.

Abstract: A surgical stapler includes a control handle having a forward-extending barrel and a stapling device at the distal end of the barrel, where the stapling device has a stapling head part, a stapler body part, and a hinge connection therebetween such that the stapling head part is pivotable relative to the barrel. The stapling head part has a holder region, opposite the hinge connection, configured for holding a surgical staple during positioning and implanting the staple. The proximal end portion of the stapling head part can be pivoted outwardly relative to the barrel to at least about 15° from an at rest position, juxtaposed with the stapler body part, to an active position for implantation of a staple into tissue in a generally proximal direction toward the control handle.

Abstract: A surgical tool for minimally invasive surgery is provided, where the tool includes a control handle; at least one vacuum arm deployable from a retracted position to an operative position for engagement with tissue in order to stabilize the tissue with respect to the tool; and a shaft movable with respect to the control handle, the shaft having an operating head movable from a retracted position to an operative position for performing a surgical function on the tissue stabilized by the at least one vacuum arm.

Abstract: Devices (11, 111) for providing temporary access to the ventricle of the heart and then closing such an access passage when the operation demanding such access has been completed. These devices include an anchor (13, 113) with a wire spiral (19, 119) for implantation in the tissue wall of the heart and a handle (15, 115) detachably connected to the anchor. The handle provides an axial passageway in which a hollow needle (27, 127) is slidably and stably received. With the anchor in juxtaposition with the apex of the heart, the pointed end of the hollow needle is inserted into the ventricle, and its presence traversing the wall of the heart provides a stable axis about which the wire spiral (19, 119) can be rotated to seat the anchor in precise circumscribing fashion about the hollow needle (27, 127).

Abstract: A surgical stapler includes a control handle having a forward-extending barrel and a stapling device at the distal end of the barrel, where the stapling device has a stapling head part, a stapler body part, and a hinge connection therebetween such that the stapling head part is pivotable relative to the barrel. The stapling head part has a holder region, opposite the hinge connection, configured for holding a surgical staple during positioning and implanting the staple. The proximal end portion of the stapling head part can be pivoted outwardly relative to the barrel to at least about 15° from an at rest position, juxtaposed with the stapler body part, to an active position for implantation of a staple into tissue in a generally proximal direction toward the control handle.

Abstract: Devices (11, 111) for providing temporary access to the ventricle of the heart and then closing such an access passage when the operation demanding such access has been completed. These devices include an anchor (13, 113) with a wire spiral (19, 119) for implantation in the tissue wall of the heart and a handle (15, 115) detachably connected to the anchor. The handle provides an axial passageway in which a hollow needle (27, 127) is slidably and stably received. With the anchor in juxtaposition with the apex of the heart, the pointed end of the hollow needle is inserted into the ventricle, and its presence traversing the wall of the heart provides a stable axis about which the wire spiral (19, 119) can be rotated to seat the anchor in precise circumscribing fashion about the hollow needle (27, 127).

Abstract: Interengaging surgical staples (11, 31, 51, 71) are provided that are useful in systems for the surgical correction of defects in cardiac valves and/or supporting weaknesses in abdominal regions. The staples are constructed with at least one ring (21, 41, 61, 81) extending laterally from the upper end of one staple leg (15, 35, 55, 75), which once implanted provides for interengagement with the next staple by passage of the other leg (13, 33, 53, 73) of it therethrough. Either shape-memory staple design or an implantation tool causes the two staple legs to curve respectively toward each other once having penetrated the tissue, thus gathering and constricting the tissue in a region below the surface thereof. Elastic sections (67, 83) may be provided in the crown connectors to allow flex in the plane thereof.

Abstract: Surgical stapling methods and tools which allow a surgeon to create several different predetermined amounts of tissue constriction using the same staple (11) loaded in such a tool (31). A stapling tool (31) holding one or more staples in an effector section (35) contains a mechanism for spreading the pointed ends of a staple to one of several spaced apart distances as controlled by an actuator-indicator (43). Depending upon the distance the pointed ends have been spread when the staple is implanted into tissue (51), the amount of constriction accomplished by the staple is varied. An improved staple construction (61) of increased rigidity is also shown.

Abstract: Adjustable annuloplasty rings for repair of a mitral or tricuspid valve which incorporate at least two separate parts that are adjustably interconnectable to create a ring the circumference of which can be changed in dimension. Rings having interconnections at spaced-apart lateral locations, which interconnections allow bidirectional movement to either shorten or lengthen the ring at either such location, afford a surgeon opportunity to make further adjustments to the dimensions of the annuloplasty ring after its initial partial securing to the heart valve tissue and thereby adjust the AP diameter of the valve being repaired. The mating interconnections at two lateral locations on the ring can be constructed so as to allow hinged movement about an axis defined by the interconnections to permit hinged movement between the two separate parts.

Abstract: Surgical stapling methods and tools which allow a surgeon to create several different predetermined amounts of tissue constriction using the same staple (11) loaded in such a tool (31). An improved staple construction (61) of increased rigidity is also shown.

Abstract: Methods for reconfiguring an atrioventricular heart valve may use systems comprising a partial or complete fenestrated annuloplasty ring proportioned to reconfigure a heart valve that has become in some way incompetent, and a plurality of staples which may have pairs of legs that are sized and shaped for association with the ring at spaced locations along its length. These systems permit relative axial movement between the staples and the ring, whereby a patient's heart valve can be reconfigured in a manner that does not deter subtle shifting of the native valve components. Shape-memory alloy material staples may have legs with free ends that interlock following implantation. One alternative is to use flexible rings that will bend in the plane of the ring as the heart beats.

Abstract: Interengaging surgical staples (11, 31, 51, 71) are provided that are useful in systems for the surgical correction of defects in cardiac valves and/or supporting weaknesses in abdominal regions. The staples are constructed with at least one ring (21, 41, 61, 81) extending laterally from the upper end of one staple leg (15, 35, 55, 75), which once implanted provides for interengagement with the next staple by passage of the other leg (13, 33, 53, 73) of it therethrough. Either shape-memory staple design or an implantation tool causes the two staple legs to curve respectively toward each other once having penetrated the tissue, thus gathering and constricting the tissue in a region below the surface thereof. Elastic sections (67, 83) may be provided in the crown connectors to allow flex in the plane thereof.

Abstract: Apparatus (20) for removing gas bubbles from a liquid to be infused to a patient wherein a gas trap (42) is located at the upper end of a vertical column (38, 40, 40a) having a lower inlet (44) and an upper outlet (56). A bracket (39) supports the column above the patient, and a bubble-separator (46, 39a, 47, 66, 63), positioned between the inlet and the outlet, causes gas bubbles to move toward the column axis as they rise so that they are captured in the gas trap (42). Liquid to be de-gasified is supplied from a vertical level above the column outlet and is delivered through the side outlet (56) to the patient below.

Abstract: Adjustable annuloplasty rings for repair of a mitral or tricuspid valve which incorporate at least two separate parts that are adjustably interconnectable to create a ring the circumference of which can be changed in dimension. Rings having interconnections at spaced-apart lateral locations, which interconnections allow bidirectional movement to either shorten or lengthen the ring at either such location, afford a surgeon opportunity to make further adjustments to the dimensions of the annuloplasty ring after its initial partial securing to the heart valve tissue and thereby adjust the AP diameter of the valve being repaired. The mating interconnections at two lateral locations on the ring can be constructed so as to allow hinged movement about an axis defined by the interconnections to permit hinged movement between the two separate parts.

Abstract: Ultrasonic devices for preventing microbubbles and/or microparticles from reaching the brain during a PCI or cardiovascular surgery. Devices 27 and 77 are designed for implantation in the chest cavity and operate in combination with needle vents or other vent systems for removing diverted microbubbles. Systems 77 and 83 are designed for noninvasive employment. Devices 57 and 87 are particularly designed to prevent microbubbles from reaching the great origins of the carotid arteries and/or for diverting bubbles that might reach the vicinity and otherwise pass through. Improved devices 11 and 94 separate microbubbles from a flowing bloodstream and produce a cleansed stream.

Abstract: Apparatus (20) for removing gas bubbles from a liquid to be infused to a patient wherein a gas trap (42) is located at the upper end of a vertical column (38, 40, 40a) having a lower inlet (44) and an upper outlet (56). A bracket (39) supports the column above the patient, and a bubble-separator (46, 39a, 47, 66, 63), positioned between the inlet and the outlet, causes gas bubbles to move toward the column axis as they rise so that they are captured in the gas trap (42). Liquid to be de-gasified is supplied from a vertical level above the column outlet and is delivered through the side outlet (56) to the patient below.

Abstract: Methods for reconfiguring an atrioventricular heart valve may use systems comprising a partial or complete fenestrated annuloplasty ring proportioned to reconfigure a heart valve that has become in some way incompetent, and a plurality of staples which may have pairs of legs that are sized and shaped for association with the ring at spaced locations along its length. These systems permit relative axial movement between the staples and the ring, whereby a patient's heart valve can be reconfigured in a manner that does not deter subtle shifting of the native valve components. Shape-memory alloy material staples may have legs with free ends that interlock following implantation. One alternative is to use flexible rings that will bend in the plane of the ring as the heart beats.

Abstract: Ultrasonic devices for preventing microbubbles and/or microparticles from reaching the brain during a PCI or cardiovascular surgery. Devices 27 and 77 are designed for implantation in the chest cavity and operate in combination with needle vents or other vent systems for removing diverted microbubbles. Systems 77 and 83 are designed for noninvasive employment. Devices 57 and 87 are particularly designed to prevent microbubbles from reaching the great origins of the carotid arteries and/or for diverting bubbles that might reach the vicinity and otherwise pass through. Improved devices 11 and 94 separate microbubbles from a flowing bloodstream and produce a cleansed stream.

Abstract: Methods for reconfiguring an atrioventricular heart valve that may use systems comprising a partial or complete annuloplasty rings proportioned to reconfigure a heart valve that has become in some way incompetent, a pair of trigonal sutures or implantable anchors, and a plurality of staples which may have pairs of legs that are sized and shaped for association with the ring at spaced locations along its length. These systems permit relative axial movement between the staples and the ring, whereby a patient's heart valve can be reconfigured in a manner that does not deter subtle shifting of the native valve components. Shape-memory alloy material staples may have legs with free ends that interlock following implantation. Annuloplasty rings may be complete or partial and may be fenestrated. One alternative method routes a flexible wire, preferably of shape-memory material, through the bights of pre-implanted staples.

Abstract: Ultrasonic devices for preventing microbubbles and/or microparticles from reaching the brain during a PCI or cardiovascular surgery. Devices 27 and 77 are designed for implantation in the chest cavity and operate in combination with needle vents or other vent systems for removing diverted microbubbles. Systems 77 and 83 are designed for noninvasive employment. Devices 57 and 87 are particularly designed to prevent microbubbles from reaching the great origins of the carotid arteries and/or for diverting bubbles that might reach the vicinity and otherwise pass through. Improved devices 11 and 94 separate microbubbles from a flowing bloodstream and produce a cleansed stream.