Abstract: A surgical device is disclosed which includes a handle assembly, an elongated member and a disposable loading unit. The handle assembly includes a mode selection mechanism configured to alternate the surgical device between a first grasping mode of operation and a second clamping mode of operation. The handle assembly includes a rotation control member and an articulation lever. The rotation control member is configured to facilitate rotation of the elongated member with respect to the handle assembly. The articulation lever is configured to facilitate articulation of the tool assembly about an axis substantially perpendicular to the longitudinal axis of elongated member. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly configured to clamp and staple tissue in the second clamping mode of operation of the device.

Abstract: A staple drive assembly includes an actuation sled and at least one staple pusher. The staple drive assembly is adapted to fit within a staple cartridge having a plurality of staples and a corresponding number of retention slots. The at least one staple pusher includes at least one pusher plate for releasably engaging a backspan of a staple. The staple pusher may include a plurality of pusher plates that may be laterally and longitudinally spaced apart. An actuation member has at least one angled camming surface for engaging a complimentary angled surface of the at least one staple pusher. Camming engagement between the actuation member and the at least one staple pusher causes vertical movement of the at least one staple pusher. Lateral and longitudinal offset of the actuation member camming surfaces and the corresponding staple pusher following surfaces improves stability and control of the staple pusher during firing.

Abstract: The present disclosure relates to electromechanical surgical systems configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue. A force transmitting assembly of surgical instrument transmits a rotation of a rotatable drive member of the surgical instrument to the rotation receiving member of the end effector. A distal neck assembly of the surgical instrument includes at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces to the end effector; and an articulating neck assembly interconnecting the tubular body and the distal neck housing. The articulating neck assembly is configured to enable off-axis articulation of the distal neck assembly. The rotatable drive member extends through the articulating neck assembly.

Abstract: A device for clamping tissue includes a first jaw having a distal portion for communicating with tissue and a proximal portion having a first wing and a second wing. The device also includes a second jaw having a distal portion for communicating with tissue and a proximal portion having a first slot and a second slot, the first slot disposed between a middle structure and a first lateral structure, the second slot disposed between the middle structure and a second lateral structure. The first jaw is rotatably coupleable to the second jaw with the first wing extending into the first slot and the second wing extending into the second slot.

Abstract: The present disclosure provides for a surgical instrument which includes a housing and an endoscopic portion extending distally from the housing and defining a first longitudinal axis. The surgical instrument also includes an end effector disposed adjacent a distal portion of the endoscopic portion. The end effector includes an anvil assembly and a cartridge assembly. The anvil assembly is pivotally coupled to the cartridge assembly to be movable from a first actuation position to at least one other second actuation position. The surgical instrument further includes a firing rod having a shaft defining a second longitudinal axis, the shaft having a cam member which is in mechanical cooperation with the anvil assembly and is configured to move the anvil assembly from the first actuation position to the at least one other second actuation position upon rotation of the firing rod about the second longitudinal axis.

Abstract: A surgical instrument including a handle portion, a body portion, a movable handle, a tool assembly, a drive beam and a closure apparatus is disclosed. The movable handle is in mechanical cooperation with a drive member. The tool assembly includes an anvil, a cartridge assembly and a contact surface. The drive beam includes a plurality of layers and at least one layer has a proximal engagement portion and is configured to engage a portion of the drive member. The closure apparatus is configured to engage the contact surface of the tool assembly. At least a partial actuation of the movable handle moves the closure apparatus distally into engagement with the contact surface to approximate the anvil and the cartridge assembly. At least one of the layers of the drive beam is affixed to an adjacent layer of the drive beam via at least one spot weld.

Abstract: A surgical device includes a shaft portion coupled to a handle, the handle defining a longitudinal axis. The surgical device also includes a first driver configured to actuate a rotational movement via a first drive shaft and a second driver configured to actuate an articulation movement via a second drive shaft. The surgical device also includes a controller having a first dial and a second dial, the first dial actuated by the first driver and the second dial actuated by the second driver, the second dial positioned within the first dial.

Abstract: A surgical stapling apparatus includes a staple cartridge and an anvil member. The staple cartridge includes a plurality of surgical fasteners disposed in rows of retention slots. The staple cartridge may have an annular or linear configuration of retention slots. The tissue contacting surface of the staple cartridge may be tapered or stepped. The anvil member has a tissue contacting surface that includes a number of pockets arranged for substantially aligning with the retention slots. In addition, the tissue contacting surface of the anvil member may complement the tissue contacting surface of the staple cartridge.

Abstract: A powered surgical apparatus, which is configured to engage tissue includes a handle assembly having proximal and distal portions, a movable portion operatively connected to the distal portion of the handle assembly, a tool assembly operatively coupled to the movable portion, a power source configured to supply electrical power, and a transmission system operatively associated with the power source. The movable portion is movable with respect to the handle assembly. The tool assembly is adapted to engage tissue. The transmission system is configured to transmit electrical power or signals between the handle assembly and the movable portion.

Abstract: A cartridge assembly is disclosed. The cartridge assembly comprises a cartridge housing and a cartridge. The cartridge housing has a plurality of biasing members thereon. The cartridge is configured for reception at least partially within the cartridge housing. The cartridge includes a plurality of fasteners at least partially therein. The cartridge has a plurality of pockets. Each fastener is ejectable from a corresponding pocket. The cartridge has a plurality of chambers, and each chamber is adjacent a pocket and configured to store at least one fastener at least partially therein. At least one fastener is movable from the chamber to the pocket. The cartridge includes a plurality of pushers, where each pusher is configured to engage at least one corresponding fastener. At least one pusher includes at least one cam surface thereon. Each biasing member urges at least one corresponding fastener toward the corresponding pocket.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing, a firing system disposed in the housing, an actuator coupled with the housing for actuating the firing system, an elongated shaft extending from the housing, the elongated shaft having an outer diameter, and a cap secured to the distal end of the elongated shaft, whereby the cap has a lower distal edge that extends laterally beyond the outer diameter of the elongated shaft. The lower distal edge of the cap has a length that is greater than the outer diameter of the elongated shaft. The cap has a distal end face that slopes upwardly and proximally from the lower distal edge, and the cap has a surgical fastener delivery window formed in the distal end face for dispensing surgical fasteners. The delivery window has a lower end that is spaced from the lower distal edge.

Abstract: The present disclosure provides annular support structures for use in conjunction with stapling devices. These annular support structures may be suitable for reducing occurrences of leaking, bleeding and/or stricture, as well as anastomotic tension, when anastomosing various body structures.

Abstract: A rotary support joint assembly for coupling a first portion of a surgical instrument to a second portion of a surgical instrument. In various forms the joint assembly includes a first annular race in the first portion and a second annular race in the second portion. The second race is configured for substantial registration with the first annular race when the second portion is joined with the first portion. A ring-like bearing is supported within the registered first and second annular races.

Abstract: The present disclosure is directed to a testing systems and methods for testing a powered surgical instrument. The powered surgical instrument includes a processor configured to control operation of the powered surgical instrument, a memory configured to store a tissue compression program, a reload configured to clamp tissue, a motor configured to control the reload to apply a compressive force to the tissue by the reload, and at least one sensor configured to measure a current draw on the motor. The processor executes the simulation program to measure the current draw on the motor through a nominal thickness firing and the measured current draw is used to adjust the tissue compression program.

Abstract: A surgical instrument including a handle assembly, an elongated portion, an end effector, and a stop member is disclosed. The end effector is disposed adjacent a distal portion of the elongated portion and includes a first jaw member and a second jaw member. At least one jaw member is movable with respect to the other jaw member between spaced and approximated positions. The first jaw member includes an upper tissue-contacting surface and a lower shelf portion. The shelf portion includes a groove disposed therein. The stop member is disposed adjacent a distal portion of the first jaw member and is pivotable with respect to the first jaw member between a first position, a significant portion of the stop member being positioned external to the first jaw member, and a second position where a lower portion of the stop member being positioned at least partially within the groove.

Abstract: Tissue thickness compensators for use with circular surgical staplers. Various tissue thickness compensators are disclosed for deployment between a stapler head of a surgical circular stapler and an anvil attached thereto to accommodate variances in tissue thickness during stapling. Some tissue thickness compensator arrangements include means and configurations for deploying healing agents for enhancing the healing process.

Abstract: A surgical stapler is provided having a pair of jaws including a staple containing cartridge and an anvil. Buttress material is releasable affixed to the staple containing cartridge and the anvil. One of the jaws includes a pair of longitudinal projections at a first end of the jaw and configured to frictionally engage corresponding slots in a first end the buttress material. One of the jaws includes a post at a second end of the jaw. The buttress material includes a hole in a second end of the buttress material for receipt of the post.

Abstract: A surgical instrument including a power assist device, and its method of use for deploying surgical fasteners, is disclosed. The surgical instrument may include a handle, an elongated shaft extending from the handle, and a surgical fastener deployment system including a driveshaft. The driveshaft is actuatable between at least a first proximal position and a second distal position. A striker is movable relative to the driveshaft and an impact surface is associated with the driveshaft. The impact surface is constructed and arranged to be struck by the striker member to displace the driveshaft to the second distal position and deploy the surgical fastener.

Abstract: A surgical stapling device including an elongated body portion having a proximal end and a distal end, and defining a longitudinal axis therethrough is presented. The surgical stapling device further includes a handle assembly positionable adjacent the body portion at the proximal end thereof and an introducer assembly positioned at the distal end of the body portion. The introducer assembly includes a sleeve positionable over at least a portion of a shell, the sleeve having a slanted distal end configured to receive a slanted membrane thereon.

Abstract: A medical device is disclosed for joining a first tubular organ (1), such as a blood vessel, to a second tubular organ (2), such as a blood vessel. The kit includes an external tubular scaffold (4) with a removable scaffold handle (7, 18, 19) and a clip (3). In use, the clip (3) and the external tubular scaffold (4) remain outside of the tubular organs (1, 2) being joined. The clip (3) embraces a first longitudinal tubular section (6) of the external tubular scaffold (4) thereby holding together a longitudinal segment of an intima of the first tubular organ (1) and a longitudinal segment of an intima of the second tubular organ (2).

Abstract: An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.

Abstract: A jaw closure mechanism for use in a surgical clip applier having first and second jaws movable relative to one another between a spaced-apart position and an approximated position to form a surgical clip about tissue. The jaw closure mechanism includes first and second eccentric wheels rotatably coupled to the respective first and second jaws. Each of the wheels includes a center and a pivot point that is offset relative to the center. A cable is disposed about each of the wheels. The cable is engaged to the first wheel at a first engagement point and to the second wheel at a second engagement point such that, upon application of a drive force to the cable, the wheels are rotated and displaced relative to the respective jaws from a first position to a second position to urge the jaws from the spaced-apart position to the approximated position.

Abstract: An apparatus for application of surgical clips to body tissue has a handle portion; a body extending distally from the handle portion; a plurality of surgical clips disposed within the body; and a jaw assembly mounted adjacent a distal end portion of the body. The jaw assembly includes first and second jaw portions movable between a spaced-apart and an approximated position. The apparatus also has a wedge plate longitudinally movable between the first and the second jaw portions, a clip pusher configured to individually distally advance a surgical clip to the jaw assembly while the jaw portions are in the spaced apart position; an actuator at least partially disposed within the body and longitudinally movable in response to actuation of the handle portion; and a jaw closure member positioned adjacent the first and second jaw portions to move the jaw portions to the approximated position.

Abstract: A tool for preparing vertebral surfaces following a discectomy has a body and a rotary cutting tool mounted at the distal end of a lever which extends through the body. The proximal end of the lever can be squeezed toward the body to force the cutting tool against the vertebral surface facing it, while the tool is rotated by turning a crank supported on the tool body, or by a motor. The cutting tool is preferably a flexible rasp or blade which can conform to and control the convexity of the prepared surface.

Abstract: The drilling device for forming an osseous channel (2) with a curved profile (2b) via a straight cannula (6) previously fixed in the body of a vertebra (3) with a cortical plateau (4) of a spinal segment (Sr) of a vertebral column (Cv) includes a guide pin (8) which is provided from a guide pin kit and has at one of its ends a curved profile (8a) of which the radius of curvature R is less than 20 millimeters, and a sharpened tip (8b) arranged in a direction defined by an angle Y which is less than 90 degrees to the longitudinal axis of said pin, the profile of said guide pin (8) making it possible to define, after insertion thereof into the body of the vertebra (3), two contact points a and b ensuring the guidance of the free end of an articulated drill bit (10) so as to position said free end in a direction substantially perpendicular to that of the cortical plateau (4) of the vertebra (3) to be drilled.

Abstract: An angular adjustment mechanism for a surgical instrument is described. The mechanism comprises an adjustment member (102) configured for rotation about a longitudinal axis (122), the adjustment member comprising a plurality of pairs of facets (134) arranged about the longitudinal axis. Each of the plurality of pairs of facets defines a respective angled axis (148B,148C) at an angle (150B,150C) relative to the longitudinal axis. A pivoting member (104) is arranged to pivot about a pivot axis perpendicular to the longitudinal axis and comprises a recess (128) for receiving the adjustment member and engaging one pair of the plurality of pairs of facets. This provides an angular adjustment mechanism in which facets on the outside of the adjustment member engage corresponding surfaces in a recess on a pivoting member. The use of facets provides a secure connection while allowing a greater degree of angular adjustment and providing a further benefit of simple operation.

Abstract: Apparatus for locating an attachment position for a reconstructed anterior cruciate ligament on an attachment surface of a bone comprises locating means 51, 61 arranged to locate at least one reference surface 4 of the bone and guide means 53, 54 arranged to define the attachment position in two dimensions on the attachment surface relative to the reference surface.

Abstract: A patellar clamp and associated system and method for using the clamp are provided. A patellar clamp includes a pair of handles movably coupled together, a patella support portion connected to the pair of handles and configured to engage a first side of a patella, and a reamer guide configured to engage a second side of the patella. The patella support portion and the reamer guide each include a first pair of flanges configured to engage a first and second tendon associated with the patella. The reamer guide is configured to allow reaming and resurfacing the entire desired posterior articular surface of the patella in a single operation without readjusting the position of the reamer guide.

Abstract: A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

Abstract: A forceps includes an end effector assembly having first and second jaw members. Each jaw member includes a proximal flange having an inwardly-facing surface. The proximal flanges are coupled to one another for moving the jaw members relative to one another between a first position and a second position for grasping tissue therebetween. The inwardly-facing surfaces of the proximal flanges are disposed in abutting relation relative to one another. A knife is configured to move along a knife path defined along an outwardly-facing surface of one of the proximal flanges. The knife is movable between a retracted position and an extended position, wherein the knife extends between the jaw members to cut tissue grasped therebetween.

Abstract: A multiple-purpose surgical instrument having a reflecting, rendering, and sizing tool to increase visibility and provide three-dimensional depth perception of a surgical site so that realization of a condition of the surgical site and safety are enhanced during an arthroscopic or laparoscopic procedure.

Abstract: A surgical instrument operable to sever tissue includes a body assembly and a selectively coupleable end effector assembly. The end effector assembly may include a transmission assembly and an end effector. The body assembly includes a trigger and a casing having a distal aperture configured to receive a portion of the end effector assembly. First and second coupling mechanism portions cooperatively couple the end effector assembly to the body assembly for use. A cartridge positionable between the instrument and a generator includes information regarding operating parameters unique to the selectively coupleable end effector assembly and/or the desired surgical procedure, such as information regarding setting a maximum current set point within an ultrasonic transducer. The instrument is programmable with operating parameter information while within a sealed and sterilized packaging unit.

Abstract: Methods and systems for resecting and debulking prostatic tissue to utilize a shaft carrying an energy source. The shaft is anchored by a balloon or other structure expanded in the bladder, and the energy source is capable of directing ablative energy radially outwardly from the urethra, where the energy source will be moved in order to remove a pre-defined volume of prostatic tissue.

Abstract: A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.

Abstract: A surgical apparatus includes an elongated member (1), a dissection module (10), and an extraction module (701). The dissection module is removably attachable to a first end of the elongated member and includes a tissue separating device (10). The extraction module is removably attachable to the first end of the elongated member and includes a suction port and a tissue removal implement (13,14) disposed within the suction port.

Abstract: Tissue severing devices having extension members that reciprocate distally and proximally and are coupled to dual reciprocating looped blades are disclosed herein. The severing devices described herein can be used during laparoscopic surgery to cut tissue of a predetermined diameter using the two looped blades.

Abstract: A valvuloplasty catheter comprises a balloon or other expansible shell which carries a plurality of scoring elements, typically formed in an elastic, self-closing metal cage. The expansible shell and scoring elements are positioned inside an aortic or other cardiac valve, and the shell expanded to engage the scoring elements against stenotic material which covers the valve leaflets and valve annulus. The scoring elements uniformly distributed force to break up the stenotic material, and the cage further contributes to rapid balloon deflation allowing shortening of the treatment time.

Abstract: A cutting device for repairing a heart valve may include a delivery catheter, a cutting unit including an elongate shaft and a plurality of cutting wires, and a plurality of centralizing wires configured to center the cutting unit within a treatment site. A method of repairing a heart valve may include withdrawing a cutting unit through a treatment site while maintaining a plurality centralizing wires in an expanded centering configuration.

Abstract: A rotational atherectomy device for removing a stenotic tissue from a vessel of a patient is disclosed. The device comprises a rotatable, flexible, hollow drive shaft having a fluid impermeable wall defining a lumen of the drive shaft and, an abrasive element mounted to a distal end portion of the drive shaft proximal to and spaced away from a distal support element formed at a distal end of the drive shaft. The distal support element is inflatable by pressurized fluid which flows in an antegrade direction through said lumen of the drive shaft and is least partially re-directed into the distal fluid inflatable support element. The distal fluid inflatable support element has an outer wall comprising an outflow opening.

Abstract: A cannula assembly includes a cannula adapted for insertion within tissue and having a longitudinal passage extending along a longitudinal axis of the cannula for passage of a surgical instrument. An expandable member is mounted to the cannula and longitudinally spaced from a distal end of the cannula. The expandable member is adapted to expand, upon introduction of fluids therein, in a radially outward direction relative to the longitudinal axis whereby the expandable member engages the tissue to facilitate anchoring of the cannula relative to the tissue, and also to expand in a radially inward direction relative to the longitudinal axis and within the longitudinal passage to engage the surgical instrument positioned within the longitudinal passage to facilitate formation of a seal about the surgical instrument.

Abstract: A surgical apparatus includes a housing member and an inner member. The housing member includes an expandable material that is adapted to transition between a compressed condition and an expanded condition. In the expanded condition, an outer surface of the housing member is adapted for a substantial sealing relationship with tissue upon insertion of the housing member within the tissue for accessing an underlying tissue site. The housing member has leading and trailing ends that define a longitudinal axis. The inner member is operably associated with the housing member and includes one or more longitudinal portals extending therethrough adapted for substantially sealed reception of a surgical object. The inner member may be less compliant than the housing member. The inner member may rotate about the longitudinal axis of the housing member.

Abstract: A trocar has an elongate body and a tissue-penetrating tip. One or more radially extending blade(s) are provided near the tissue-penetrating tip of the trocar body so that they automatically open as the trocar is advanced through tissue. The blades will enlarge the penetration which was formed by the tip of the trocar.

Abstract: An obturator provides access to a joint through a capsule surrounding the joint. A distal end of the obturator has a first distal location with a first width dimension and a second distal location with a second width dimension, wherein the second distal location is proximal to the first distal location and the second width dimension greater than the first width dimension. A retractable blade can extend from the obturator to be exposed between the first distal location and the second distal location.

Abstract: A new and useful apparatus and method are provided for removing a foreign object from a rectal cavity. An anoscope is configured for insertion through the anus into a rectal cavity. The anoscope has a base and introducer with guides that route flexible members and a flexible sheath that are carried by actions of the operator through the anoscope beyond the guide and further into a rectal cavity and to expand about a foreign object in the rectal cavity. The anoscope also carries a noose that is manipulatable from outside the patient's rectal cavity to tighten and stricture the flexible sheath above the foreign object and capture the foreign object within the flexible sheath, so that the foreign object can be manipulated by the noose and the flexible sheath to remove the foreign object from the rectal cavity once the anoscope and flexible ribs are removed from the anus.

Abstract: A coupling assembly is presented. The coupling assembly is used to selectively couple a bone screw having an elongate shaft and a head to an elongate rod. The coupling assembly has a coupling element configured to engage the head of a bone screw, as well as the elongate rod. When the elongate rod is engaged by the portion of the top of the coupling element, the coupling element does not extend above a top most portion of elongate rod.

Abstract: Anchor for attachment to a bony structure, comprising a hook, an anchor body with a distal wall facing the hook, and a fastening system for fastening a connection member to the anchor body. A slot is defined between the hook and the distal wall, for receiving a bony structure such as a vertebra portion. The anchor further comprises a retention member having a distal end with teeth, passing through the distal wall and being movable relative to the anchor body, from a retracted position to a protracted position where the distal end protrudes from the distal wall, inside the slot. The proximal end of the retention member defines a seat for the connection member.

Abstract: The present invention provides a connection assembly that can be used to securely connect a spinal implant to a bone anchor. In particular, the present invention preferably provides a spinal implant connection assembly that is able to securely connect the spinal implant to the anchors even when there is a variance in the angle and position of the anchors with respect to the spinal implant. Furthermore, the present invention provides a connection assembly with structure to increase the locking strength of the connection assembly.

Abstract: A spinal implant with at least one flexible elongated extension element is provided. The spinal implant has a profile that is lower than standard spinal implants. The spinal implant includes a bone anchor with a head portion and a shaft extending along a longitudinal axis of the bone anchor. A head plate is coupled to the bone anchor. The head plate includes a first elongated extension element and a second elongated extension element. The first elongated extension element and the second elongated extension element may be formed as a single monolithic element that is attached to the head plate by passing through a pair of openings provided on the head plate. At least one of the first elongated extension element and the second elongated extension element is flexible.

Abstract: A receiving part for coupling a rod to a bone anchoring element includes a receiving part body having a first end, a second end, a channel for receiving a rod, an accommodation space for accommodating a head of a bone anchoring element, and an opening at the second end for inserting the head, and a pressure element configured to be positioned at least partly in the accommodation space, the pressure element having a first end, a second end, a central axis, and a flexible portion to clamp an inserted head. The flexible portion has a first slit spaced apart from the second end of the pressure element that extends at least partially around the central axis, and a second slit that extends from the second end of the pressure element into the first slit. The first slit extends away from the second slit and is longer than the second slit.

Abstract: An interspinous fusion device is described. The interspinous fusion device includes a spacer member and an anchor member. The spacer member has a ring with two or more anchor assemblies projecting laterally from substantially opposite sides of the spacer member ring. The spacer member further has a first zip lock flange and a second zip lock flange, each of the first and second zip lock flanges extends transversely from the spacer member ring wherein each of the first and second zip lock flanges each comprises a series of teeth protruding from it. The anchor member has a ring with two or more anchor assemblies projecting laterally from substantially opposite sides of the anchor member ring. The anchor member further has a barrel extending transversely from the anchor member ring. The barrel comprises a first column of recesses adapted to mate with the teeth of the first zip lock flange and a second column of recesses adapted to mate with the teeth of the second zip lock flange.