Abstract: In a rising gathered member 4 of an absorbent main body 3 attached to an external sheet 2, an inward folded base end 4b is joined astride a side end 13a of a top sheet 13 as a top surface of the absorbent main body 3 and a side end 14a of a back sheet 14 so that the rising gathered member 4 rises from a most side edge 3a in a width direction of the absorbent main body 3 and, also, the back sheet 14 of the absorbent main body 3 is attached onto a skin-contacting surface side of a crotch part R of a second external sheet 8 at an inward position at a prescribed width W5 from the most side edge 3a of the absorbent main body 3 as an outermost joint position. With the above constitution, it is possible to effectively prevent any lateral leakage of urine and the like, even if a disposable absorbent article is shifted.

Abstract: A disposable pull-on diaper includes front and rear waist regions and a pair of tape fasteners secured to an outer surface of the front waist region or the rear waist region. A tape member forming each of the tape fasteners has a distal end portion and a proximal end portion wherein the distal end portion is releasably attached to joining zones along which the front and rear waist regions are joined together.

Abstract: A laparoscopic port assembly includes a cannula unit including three cannulas each extending at an acute angle relative to a base. The cannulas are flexible for receiving respective angulated laparoscopic instruments. The cannula unit is rotatingly received in a port holder for rotation about a longitudinal axis of the holder, the holder being disposable in an opening in a patient's skin.

Abstract: The present invention is directed to a system and method for monitoring the physiological parameters of an organ or tissue during and after surgery. The system has a probe and a monitoring unit. In one embodiment the probe includes features for convenient, fixed and releasable attachment to surgical drains without interfering with their normal fluid-draining function while utilizing their suction to enhance the probe-to-tissue interface for improved sensing. An applicator is provided to facilitate such attachment. The monitoring unit which controls the sensors of the probe includes a processor to process, record and display the sensor data. This system may be valuable for monitoring transplanted organs and tissue grafts during the critical postoperative period when most of the clinical complications, such as vascular thrombosis, may occur.

Abstract: A method for monitoring biological substances found in the bloodstream include implanting in-vivo a pedestal such that a sensor mounted on the pedestal extends into the bone marrow for sensing the biological substance. A transmitter is included for transmitting signals from the sensor to a receiver.

Abstract: A surgical instrument particular suited to endoscopic use is disclosed. Various embodiments include an end effector that is sized to be inserted through a trocar. An elongated shaft assembly is coupled to the end effector and a control handle. The elongated shaft assembly has a distal portion that is adjacent to said the effector for insertion into the trocar. The elongated shaft assembly further has a proximal portion that is remote from the distal portion such that the proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough. The control handle is articulatably coupled to the proximal portion of said elongated shaft assembly to enable the surgeon to move the handle portion to a more ergonomically comfortable position while carrying out the endoscopic procedure. Various articulation joint embodiments and locking arrangements are disclosed.

Abstract: A cryogenic catheter includes an outer flexible member having at least one cryogenic fluid path through the flexible member. The at least one fluid path is defined by a plurality of flexible members disposed within the outer flexible member.

Abstract: A catheter is provided having anchoring and stabilizing devices adapted to respectively sit in and outside an opening of a tubular region. A sheath covering the catheter body forms the anchoring and stabilizing devices, which sheath comprises slits cut into the sheath creating spines. The spines are radially expanded by distal movement of the sheath relative to the catheter body. Radial expansion of the anchoring device generally anchors the distal end of the catheter inside the tubular region. Radial expansion of the stabilizing assembly generally stabilizes the distal end of the catheter against the ostium of the tubular region. The pressure exerted on the tubular region by the anchoring and stabilizing devices minimizes translational and rotational movement of the distal end of the catheter. Alternatively, the catheter may include a telescoping portion extending from the distal end of the catheter in which the anchoring and stabilizing devices are deployed by movement of a puller wire.

Abstract: Medical systems and related methods are disclosed. In some embodiments, the medical systems include a catheter, an expandable medical device at least partially surrounding a portion of the catheter, a blade attached to the medical device, and an energy transmitter configured so that energy emitted by an energy source can be transmitted to the blade via the energy transmitter.

Abstract: An apparatus for use with a clamp including a base member configured to be secured to the clamp and at least one energy transmission device carried by the base member. An apparatus for use with a clamp and a probe that carries at least one energy transmission device including a base member configured to be secured to the clamp and an engagement device associated with the base member and configured to engage the probe. A clamp including first and second clamp members, at least one of which is malleable, and a movement apparatus that moves at least one of the first and second clamp members relative to the other. A surgical system including a clamp with first and second clamp members and a device that removably mounts at least one electrode on at least one of the first and second clamp members.

Abstract: An electrode sealing assembly for use in combination with an electrosurgical instrument includes first and second jaw members which are movable from a first, spaced-apart position to a second position to grasp tissue. Each of the jaw members includes an insulative housing, a thermally conductive, electrically non-conductive material and a sealing plate. The insulative housing has a series of electromechanical interfaces which mate with a corresponding series of electromechanical interfaces which extend from the sealing plate such that the sealing plates are a capable of conducting bipolar energy through tissue held between the jaw members. The thermally conductive, electrically nonconductive material is configured to encapsulate and secure the sealing plate to the insulative housing.

Abstract: A device is presented for temporarily mounting an image tracker to a patient during surgery. The device preferably includes a first aperture and a axially-align second aperture. The apertures are sized to receive a securing mechanism, such as a bone screw that is temporarily inserted into a patient's bone for holding the image tracker near the vicinity of a surgical site. The device further preferably includes at least one projection such as a pin to stabilize the device from rotating.

Abstract: Methods and instrumentation for vertebral interbody fusion are provided. Sleeve assemblies can be provided with a reduced width portion adjacent the distal end to limit the amount of retraction of the surrounding vascular and neural structures required for the procedure. A sleeve assembly can be provided with a guide sleeve removably engaged to a guide sleeve housing. The guide sleeve can be removed during surgery to improve the surgeon's viewing of the operative site while the guide sleeve housing maintains disc space distraction. Methods and instruments for inserting and using the guide sleeve housing are also provided.

Abstract: An apparatus and method for distracting, in a given direction, and supporting two tissue surfaces is disclosed using a column of wafers. The column of wafers is oriented so as to expand in the given direction as the wafers are consecutively added to the column. A wafer insertion apparatus includes a wafer cartridge configured to carry a stack of wafers to be inserted into the space, a track assembly including a first track for carrying a wafer toward the space, a second track and means for preventing retrograde movement of a wafer within the first track, an advancer/pusher mechanism slidably disposed within the second track and operable on a wafer within the first track to advance the wafer along the first track, and an advancement gun operably coupled to the advancer/pusher mechanism to propel the mechanism along the second track.

Abstract: A device and method for targeting objects and specifically for locating intramedullary screw openings is described. The device and method include a target magnet and a sensor comprising an elliptical array of magnetoresistive elements, designed to give information on the three-dimensional orientation of the magnet. The sensor array is designed such that each magnetoresistive element is a member of an opposing pair and relays information on their alignment with the target magnet. The array is connected to a display such that the position of the sensor in relation to the target magnet is easily discerned. The invention is lightweight and portable, capable of operating on batteries and can be used in primitive situations where a stable supply of electricity is not available.

Abstract: A depth gage for use with a drill in orthopaedics is provided. The depth gage includes a body. The body has first and second ends opposed to each other and an inner periphery defining a longitudinal aperture through the body for slidably receiving the drill. The longitudinal aperture defines a longitudinal axis of the longitudinal aperture. The body is adapted to permit the drill to be positioned in the longitudinal aperture in a direction non-coincident with the longitudinal axis.

Abstract: Bone length adjustment method and system includes a two-part telescopic device connected to bone parts whose length between the connection points is to be adjusted, with each part of the telescopic device being secured to the bone part, and a rod with an embedded permanent magnet which is in threaded engagement at one or both of its ends with one or both of the parts of the telescopic device. The permanent magnet in the rod is excited by an external solenoid arrangement to cause a radial force to develop at the rod thereby causing it to rotate. Rotation of the rod is converted via the threads at one or both of its ends to axial motion or movement of the telescopic parts relative to each other and thereby causes an increase or decrease in the bone length depending on the direction of axial movement between the telescopic parts.

Abstract: An apparatus and methods for delivering ocular implants or microimplants. The apparatus is ergonomically designed for ease of use, and a simple manual depression of an actuator produces proportional movement of a linkage causing the implant or microimplant to be ejected through a cannula disposed at the desired location in the eye. Small gauge cannulas are provided for self-sealing methods of delivery.

Abstract: A medical grasping device (10) for vascular use, having an outer sheath (12), an elongate control member (50) extending within an outer sheath (12) to a distal tip section (54), and a proximal control assembly (22) including an actuation section (24) joined to the elongate control member (50). Adjacent to the distal tip section (54) is a grasping portion (70, 70?) that is extendable from the outer sheath (12) to create loops (74, 74?) for grasping a target object (T) for repositioning within the vascular system, or for removal from the patient, with loops being retractable into the outer sheath to hold the target object against the device (10) during movement of the device. Elongate control member (50) is preferably a cannula or tube having a lumen (58) extending completely therethrough for placement over a guide wire (28) already in the patient.

Abstract: A medical grasping device (1) has an elongate control member (9) with a grasping member (17) proximal to its distal tip. An outer sheath (3) with a passageway therethrough surrounds the elongate control member and is relatively movable with respect to the control member. A control assembly (2) disposed at a proximal end of said outer sheath has a fixed handle (5) and a sliding handle (7) and the proximal end of the elongate control member is fixed to the sliding handle to move the control member. The grasping member (17) has a plurality of pre-formed wire loops (50, 52, 54, 56) which self-deploy transversely upon emerging from said distal end of said outer sheath. Each wire loop is fastened to substantially opposite sides of the elongate control member so that each of said wire loops is substantially semi-circular upon full deployment and the respective ends (27, 29) of each wire loop extend substantially in opposite directions from the elongate control member.

Abstract: A wire for removing an intravascular foreign body comprises a flexible wire body, a branch part branching out from the forward end of the wire body, and a plurality of filaments extending across the branch part. The branch part and the filaments form a space for capturing a foreign body therein. At least one of the filaments is changeable in length so that the loop formed by the filament and the branch part changes in size. The wire is capable of relatively reliably capturing and removing a foreign body in the vessel.

Abstract: A surgical apparatus for cutting a tissue mass comprising an elongated housing having a distal portion, a rotatable shaft positioned in the elongated housing, and a plurality of flexible electrocautery cutting blades extending from the housing, wherein the plurality of cutting blades are radially expandable from a first position defining a first diameter to a second larger diameter and the blades are rotatable and transmit electrical energy to cut the tissue mass.

Abstract: Methods and apparatus for determining the orientation and the position of an object in space with the assistance of a sensing instrument are provided. The sensing instrument is provided with a marking element. The orientation and position of the marking element is determinable by means of the navigation system. In order to be able to carry out a reliable determination of the position, even under confined conditions of access, the sensing instrument is adapted to be successively connected in a guided manner to the object for free rotation about two non-parallel, defined axes of rotation. The sensing instrument can be rotated about these axes of rotation, and the orientation and the position of the two defined axes of rotation in space and hence the orientation and the position of the object in space can be calculated from the resulting movement of the marking element during this rotation.

Abstract: Devices and methods generally provide enhanced stabilization, exposure and/or treatment of a cardiac valve annulus. Methods generally involve introducing a stabilizing member beneath one or more leaflets of a heart valve to engage the annulus at an intersection between the leaflets and the interior ventricular wall of the heart. Force is then applied to the stabilizing member to stabilize and/or expose the valve annulus. In some embodiments, the stabilizing member may include a series of hydraulically driven tethered anchors, such as hooks or clips, for engaging and cinching valve annulus tissue to decrease the diameter of a regurgitant valve. Alternatively, other treatments may be delivered by a stabilizing member, such as radiofrequency energy, drugs, bulking agents or shape memory stents. A second stabilizing member may also be introduced above the leaflets for further stabilization.

Abstract: The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.

Abstract: Devices, systems and methods facilitate positioning of a cardiac valve annulus treatment device, thus enhancing treatment of the annulus. Methods generally involve advancing an anchor delivery device through vasculature of the patient to a location in the heart for treating the valve annulus, contacting the anchor delivery device with a length of the valve annulus, delivering a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus, and drawing the anchors together to circumferentially tighten the valve annulus. Devices generally include an elongate catheter having at least one tensioning member and at least one tensioning actuator for deforming a distal portion of the catheter to help it conform to a valve annulus. The catheter device may be used to navigate a subannular space below a mitral valve to facilitate positioning of an anchor delivery device.

Abstract: An occlusive device includes a hollow cylindrical element which can be twisted axially in order to create a constricted region. The device also includes a body which can be deformed by transverse compression and which is applied against the inner wall of the aforementioned cylindrical element, the body having a through hole along the axis of the cylindrical element.

Abstract: Embodiments include, a medical device having a balloon portion with a first end, a second end, and a variable balloon mass to inflate the balloon portion non-uniformly from the first end to the second end. In one embodiment, the balloon portion inflates in a controlled manner to rupture a vulnerable plaque near the second end.

Abstract: A corneal punch comprising a base unit having a first annular mating surface surrounding a well in which a donor cornea may be located, and a separate guide unit including an inner annular guide shaft and an outer locating ring connected to the guide shaft and having a second annular mating surface. The base unit and the guide unit may be releasably positioned in registration with each other by way of the first and second mating surfaces such that the guide shaft is substantially coaxial with the well.

Abstract: A space occupying device for deployment within a patient's stomach and methods of deploying and removing the device. The device includes an expandable member and fasteners, such as sutures, that extend to least partially through the patient's stomach wall, and that anchor the device with the patient's stomach. The device can be deployed and/or removed through transesophageal approaches and/or through a combination of transesophageal and transabdominal approaches.

Abstract: A method of treating a patient's sphenoid sinus having an obstructed or narrowed sphenoid ostium. A balloon of a balloon catheter is inflated in the obstructed or narrowed sphenoid ostium to enlarge the ostium. The ostium remains enlarged after the balloon catheter is removed.

Abstract: A method of treating a patient's maxillary sinus having an obstructed or narrowed maxillary ostium. An opening is created into the maxillary sinus. A balloon of a balloon catheter is inflated in the opening to enlarge the opening. The opening remains enlarged after the balloon catheter is removed.

Abstract: An apparatus and method for introducing a medical device deployment system into the vasculature of a human body and then using the deployment system for placing a medical device at a preselected position within a vessel, and an apparatus and method for introducing a medical device deployment system into the vasculature of a human body and then subsequently retrieving the deployment system, where the apparatus and method include an introducer having a detachable and reattachable sheath disposed about a deployment catheter.

Abstract: Embodiments of the invention relate to a medical device having a proximal portion that can selectively receive other portions of the device. More specifically, embodiments of the invention relate to an endoscopic instrument with a handle portion configured to accommodate an elongate, flexible member and an end effector assembly of the endoscopic instrument for protection, coiling, looping, containment, packaging and for disposal. The device may have a variety of configurations.

Abstract: An apparatus for sealing a passage through tissue includes a bioabsorbable, threaded plug carried by a delivery device. A guide wire is receivable through lumens in the plug and delivery device that includes wings on a bioabsorbable distal portion. With the wings collapsed, the guide wire is advanced through the passage into a blood vessel, the wings expanding once located within the vessel, and the guide wire is withdrawn until the wings contact the vessel wall. The plug is threaded into the passage over the guide wire until the plug is disposed adjacent the wings. The distal portion of the guide wire is secured to the plug, e.g., by compressing a collet within the plug lumen that seals the lumen, and is severed from a proximal portion thereof. Thus, the plug and distal portion are deployed with the plug sealing the passage.

Abstract: A surgical closure method utilizes a surgical device including an elongate tube, a flexible web member disposed in a collapsed configuration inside the tube, and a push rod disposed at least partially inside the tube for pushing the web member from the tube. A distal end portion of the tube is inserted through an opening or wound in a wall of a hollow body organ. The rod is pushed in a distal direction along the tube to eject the web member from the distal end of the tube. The ejected web member is expanded from the collapsed configuration to an expanded configuration. The expanded web member is placed in contact with the wall of the organ over the opening or wound. Subsequently the expanded web member is attached to the wall of the organ.

Abstract: An interventional medical closure device is suitable for assisting closure of an opening through a blood vessel wall after completion of an interventional procedure within the internal lumen of the blood vessel. The device comprises a closure element, a grasping element for grasping the closure element, and a delivery element for delivering the closure element into the internal lumen of the blood vessel. The closure element comprises a suture, and an engagement foot at a distal end of the suture. The grasping element is inter-engageable with the closure element to grasp the closure element. The delivery element comprises a main body portion, and a distal nose. The distal nose defines a reception space for carrying the engagement foot of the closure element. The delivery element also comprises an engagement foot which is movable relative to the main body portion between a low-profile delivery configuration and a protruding engagement configuration.

Abstract: A fastening device for clamping and fastening tissue together with fasteners formed from an adhesive is disclosed. An embodiment of the adhesive fastening device can clamp a first and a second portion of tissue together between a first and a second jaw, and can place a fluid polymer adhesive into tissue and form it into a polymerized surgical fastener within the tissue. The adhesive fastener can be formed as a polymerized shank or shaft extending through the tissue, and can have one or more heads formed on the shank. The shank can be formed solely from the polymerizable adhesive, or can be formed from another material such as nitinol, titanium, stainless steel, suture, or a plastic. Shanks of other material can be combined with the adhesive. Alternately, an adhesive fastener can be formed extending distally from a distal end of the surgical device. And, an adhesive fastener can be formed around a luminal tissue or within luminal tissue.

Abstract: Superior and/or inferior facets of one or more facet joints may be replaced by superior and/or inferior facet joint prostheses. In one embodiment, a kit of superior or inferior prostheses is provided, in which the prostheses have at least two dimensions that vary among members of the kit independently of each other. Each prosthesis may have a bone engaging surface having a surface that is polyaxially rotatable against a corresponding resection of a vertebra. Each prosthesis may also have an articulating surface shaped such that, after attachment to the spine, the replaced or partially replaced facet joints provide a larger medial-lateral range of motion when the spine is flexed than when the spine is extended. Crosslinks may be used to connect left and right prosthesis together in such a manner that they are stabilized in a position in which they are seated directly against the vertebra.

Abstract: A device for treating spinal stenosis having an implant body structure sized and configured to be positioned between the spinous processes of two adjacent vertebrae. The device may have a body portion having a first end portion, a second end portion and a sleeve between the first and second end portions. The device may also have at least two retainers positioned in and extendable from the body portion. A mechanism positioned within the body portion may be used to move the retainers between a retracted position and a deployed position. When the retainers are in the deployed position, the retainers may be positioned around the spinous process of at least one of two adjacent vertebrae. A plurality of installation tools may be used to install the device.

Abstract: A surgical implant assembly, and components thereof, are disclosed. Such assemblies include a connector device and an anchoring shaft. The assemblies are useful for insertion into bone and connecting a foreign object to bone via a polyaxial coupling mechanism.

Abstract: A lateral connector assembly for connecting a bone engaging fastener to an elongated member, such as a spinal rod includes a lateral connector having an opening for receiving a portion of the bone engaging fastener therethrough. The lateral connector includes a plate portion and an integral yoke portion, which yoke portion is attached to the elongated member by way of a clamp. The lateral connector assembly can include variable angle means between the clamp and the yoke portion of the lateral connector that permits rotation of the lateral connector about an axis projecting outward from the spinal rod. The clamp includes a tapering channel to capture the elongated member and lock the connector assembly.

Abstract: Devices and methods for treating a damaged intervertebral disc to reduce or eliminate associated back pain. The present invention provides disc reinforcement therapy (DRT) which involves implanting one or more reinforcement members in and preferably around the annulus of the disc. The reinforcement members may be used to stabilize the annulus and/or compresses a portion of the annulus so as to reduce a bulge and/or close a fissure. The implantable devices and associated delivery tools may incorporate heating capabilities to thermally treat the annular tissue. Alternatively or in combination, other devices may be specifically employed for such thermal treatment.

Abstract: A fixture which is intended to be screwed firmly into bone tissue. The fixture includes a generally cylindrical anchoring portion provided with an external screw thread. The anchoring portion includes a cavity which extends from the insertion end of the anchoring portion. A number of slots which connect the cavity with the outside of the anchoring portion extend from the insertion end of the anchoring portion. Each slot is delimited by a leading slot wall and a trailing slot wall, the leading and trailing slot walls rotating in the direction defined by the screw thread when screwing in the anchoring portion. At least the radially outermost part of the trailing slot wall defines an angle with the radial direction and is inclined obliquely forward from within and outward in the direction of rotation.

Abstract: The invention relates to the use of reduced fluency rate PDT to treat neovasculature, particularly choroidal neovasculature (CNV). Reduced fluency rate PDT decreases the likelihood of molecular oxygen being the limiting factor in the photodynamic reaction so that the concentration of either photons (light intensity) or photosensitizer in the target tissue controls the photodynamic reaction.

Abstract: The invention relates to a treatment probe for focused ultrasound including a probe body, which is mounted in rotation around an axis; an elongated treatment transducer with a focused ultrasound emission acoustic axis, which is more or less the same as the rotation axis of the probe body; and an imaging transducer, the imaging plane of which contains the acoustic axis of the treatment transducer. The inventive probe can be used to provide a simple treatment. The probe body can be rotated around the axis in order to vary the direction of the imaging plane without moving the focus, which always remains in the imaging plane. The treatment transducer can be extended in order to provide safer treatment in relation to the organs to be treated and without risk of damaging the fragile surrounding organs.

Abstract: The present invention is directed to a deployment system for an endoluminal device. The deployment system includes a confining sheath placed around a compacted endoluminal device. A deployment line is provided in the system that is an integral extension of the sheath. As the deployment line is actuated, the sheath retracts from around the compacted endoluminal device. As the sheath retracts from around the endoluminal device, material from the sheath may be converted into deployment line. Once the sheath is retracted from around the compacted endoluminal device, the endoluminal device expands in configuration and repairs vascular or cardiac structures of an implant recipient. Any remaining sheath material is removed from the implantation site along with the deployment line. The deployment system also includes an endo-prosthesis mounting member placed between the endoluminal device and an underlying catheter.

Abstract: Minimally invasive techniques are utilized in bypass grafting to implant an end portion of a graft in the body of a patent by (i) advancing a medical instrument within a circulatory system of the body, (ii) guiding a distal end of the medical instrument out of the circulatory system through an opening defined in the circulatory system, (iii) advancing the end portion of the graft within the medical instrument toward a surgical site, and (iv) securing the end portion of the graft to a blood vessel at the surgical site, wherein the graft includes resilient arms confined within the medical instrument that expand outwardly within the blood vessel following positioning of a graft end through an aperture in the blood vessel.

Abstract: Fine structure stents physiologically acceptable to the body.

Abstract: A beam is provided for intraluminal devices. The beam is defined by a first side surface and a second side surface. The first side surface is tapered at a different rate than the second side surface. One advantage of the beam is that strain which is normally concentrated in adjacent, interconnected bends is redirected onto the length of the beam. This may increase the fatigue life of intraluminal devices or may be used to fashion new structures with improved performance.