Abstract: A method for data acquisition in PET may be provided. The method may include obtaining, based on outputs of multiple pairs of detectors of a Positron Emission Tomography (PET) scanner, coincidence events corresponding to multiple LORs. The outputs of the multiple pair of detectors may be acquired during a PET scan on a subject. The method may also include determining, based on a count of coincidence events corresponding to each LOR of at least a portion of the multiple LORs, a detection rate corresponding to the LOR.

Abstract: The disclosure is directed to an MR-PET apparatus with a patient table and a plug-in connecting unit having at least one plug-in connecting element arranged on the patient table. The at least one plug-in connecting unit may be designed to enter into a releasable connection with a corresponding plug-in connecting element of an external apparatus. A position of the at least one plug-in connecting element may be adjustable and the plug-in connecting unit has an adjusting unit for an independent adjustment of a target position of the at least one plug-in connecting element on the patient table.

Abstract: In one embodiment, a method of obtaining a computed tomography scan of a region of interest includes determining a region of interest. The region of interest is a portion of an object being scanned. The method also includes selectin an appropriate static filter of a pre-patient collimator from a plurality of pre-patient collimators and positioning the selected static filter of the pre-patient collimator in a path of an x-ray beam. The method may also include adjusting a table of the CT system to position the region of interest in the path of the region of interest.

Abstract: The present technology relates to interatrial shunting systems and methods. In some embodiments, the present technology includes a method for monitoring a shunting element implanted in a patient and having a lumen fluidly coupling cavities of the patient's heart. The method can comprise obtaining first and second radiographic images of at least two radiopaque elements associated with the lumen of the shunting element. A spatial relationship between the radiopaque elements varies according to a size of the lumen. The first radiographic image can be taken from a first viewing angle and the second radiographic image can be taken from a second viewing angle generally orthonormal to the first viewing an The method also includes determining the size of the lumen based, at least in part. on locations of the radiopaque elements in the first and second radiographic images.

Abstract: The present invention includes systems and methods for dental imaging using near infrared (NIR) light to illuminate a tooth (or teeth) using a sensor, such as a camera, to obtain a single image for each view of the tooth (or teeth) imaged for a dental assessment.

Abstract: The invention relates to an X-ray imaging system comprising a mobile base (10), a motorized arm (20), and a C-arm (30) adapted to be mounted on the mobile base (10) by means of the motorized arm (20), wherein the C-arm (30) comprises an X-ray source (31) and an X-ray detector (32), wherein the motorized arm (20) presents at least three rotation axes (Z1, Z2, Z3) directed along a substantially common vertical direction (Z).

Abstract: A method for visualizing tissue of a subject includes receiving a first series of first imaging modality frames generated by imaging a region of tissue of the subject, and a first series of second imaging modality frames generated by imaging the region of tissue; displaying the first series of first imaging modality frames in combination with the first series of second imaging modality frames; storing a plurality of first imaging modality frames and a plurality of second imaging modality frames of the first series of second imaging modality frames in a memory; receiving a second series of first imaging modality frames generated by imaging the region of tissue; and displaying the second series of first imaging modality frames in combination with one or more of the second imaging modality frames of the first series of second imaging modality frames stored in the memory for visualizing the region of tissue.

Abstract: A C-arm imaging system includes a C-arm, and a sliding support assembly. The C-arm includes a first end portion and a second end portion which are oppositely disposed. The first end portion is used to connect to the X-ray tube assembly, while the second end portion is used to connect to the detector assembly, and the X-ray tube assembly and the detector assembly are aligned. The sliding support assembly is connected to the C-arm, and the C-arm can slide relative to the sliding support assembly, wherein the C-arm rotates at a rotational angle of not less than 90 degrees relative to the sliding support assembly from a first position to the first end portion or the second end portion, the first position being a position where the line connecting the center of the detector assembly and the center of the X-ray tube assembly is in a vertical direction.

Abstract: A computer-implemented method for generating training data for training an algorithm for estimating positioning variances in an imaging apparatus of an x-ray imaging system is provided. The method includes predetermining target positioning data for the imaging apparatus and calculating faulty positioning data, wherein the faulty positioning data deviates from the target positioning data by at least one predetermined positioning variance. An imaging method is simulated, in order to generate two or more simulated x-ray recordings, wherein a positioning of the imaging apparatus is simulated in accordance with the faulty positioning data. An annotated training data record is generated and stored, wherein the training data record contains two or more simulated x-ray recordings and at least one positioning variance as an annotation of the two or more simulated x-ray recordings.

Abstract: The present disclosure is related to systems and methods for controlling an imaging device. The system may include an imaging device, a voice processing device, and a terminal. The imaging device may be configured to image a subject. The voice processing device may be configured to receive a first voice signal from or transmit a second voice signal to the subject when the subject is positioned within the imaging device. The terminal may be configured to receive a third voice signal from or transmit a fourth voice signal to a user.

Abstract: A method for use in a material decomposition procedure applied to dual-energy CT projection data. Material decomposition is often done using pre-computed lookup tables (LUTs) for mapping input projection data, acquired with particular X-ray source parameters, to material data values. However, the X-ray source parameters can vary over the course of a scan, making the results inaccurate. Embodiments are based on determining in advance a plurality of sets of basis LUTs for each of a plurality of different possible ranges of values over which the X-ray source parameter may vary during a scan. The basis LUTs in each set are devised as being LUTs which represent the majority contribution to the overall material decomposition function for the time-varying energy spectrum.

Abstract: In some embodiments an X-ray system comprises a work-station and a mammography apparatus. The mammography apparatus can comprise: a breast positioning area; a diffraction enhanced X-ray imaging apparatus; and a diffractometer for analyzing structure of tissue within a breast. The diffraction enhanced X-ray imaging apparatus and the diffractometer can be configured to move in order to interchangeably align with the breast positioning area. The work-station can be configured to control, and to process data received from, the mammography apparatus.

Abstract: System and related method for supporting a balloon catheter (BC) procedure. The system comprises an input interface (IN) for receiving input data. The input data comprises i) image data acquired of a balloon catheter in a vessel of a patient (PAT), and ii) one or more pressure readings collected by a pressure sensor (S) of the balloon catheter (BC). A trained machine learning module (MLM) is configured to predict, based on the input data, a prediction result including an event in relation to i) the balloon catheter and/or ii) a section of a vessel in which the balloon catheter is residable.

Abstract: A method for segmenting aortic tissues (or detecting calcification) in an image of a body of a given subject, the method executed by a processor having access to at least one deep learning model trained to segment aortic tissues in images, the method including: receiving the image of the body of the given subject, the image being an aorta, an intraluminal thrombus and additional body parts; extracting a region of interest from the received image, the region of interest being the aorta and the intraluminal thrombus; determining, within the region of interest, a presence of a calcification on at least one of an aortic wall and the intraluminal thrombus; and outputting an indication of the presence of the calcification.

Abstract: A method is provided for estimating blood velocity in vessel, for example for use in deriving a measure of blood flow through the vessel. The method comprises two stages. In a first stage, multiple measurements of blood velocity are acquired, using ultrasound data, at different radial positions across a blood vessel cross-section. A velocity profile is determined (velocity as a function of measurement location across the vessel cross-section) based on this. In a second stage, in one or more subsequent cardiac cycles, new ultrasound data is acquired and a blood velocity measurement acquired at a single location. The single blood velocity measurement preferably corresponds to a location of maximum velocity. This single measurement, in combination with the personalized velocity profile already derived, is used to derive a measure of average blood velocity within the vessel.

Abstract: An ultrasound diagnosis apparatus includes: a transmission and reception circuitry configured to perform, via an ultrasound probe, a first ultrasound scan on a first region in a subject who has a contrast agent injected and a second ultrasound scan on at least a part of a second region in the subject overlapping with the first region, the second ultrasound scan including transmitting and receiving two types of ultrasound waves of which one or both of amplitude levels and phases are different from each other; and processing circuitry configured to generate a blood flow image corresponding to one frame by implementing a Doppler method on the basis of a data sequence including reception data obtained from the first ultrasound scan performed multiple times in mutually the same position within the first region to have the second ultrasound scan performed in-between and to generate a contrast-enhanced image based on a result of the second ultrasound scan performed at least one time.

Abstract: Passive pressure sensors for use in a shunt valve system or other intracranial implants, for measurement of intracranial pressure of cerebrospinal fluid within the brain cavity. Such a pressure sensor implant can be very simple, e.g., including only a micro-membrane configured as a diaphragm, formed of a biocompatible polymer or other material (e.g., PMMA, PDMS, PEEK, polyimide or a biocompatible hydrogel), and an associated air cavity, without any required electronic components. The diaphragm, or air cavity are configured to exhibit changes in response to changes in CSF pressure, which can be detected through ultrasound readout. Ultrasound query at specific frequencies can be used to track such changes which can be correlated to intracranial pressure. Such an ultrasound readout is completely remote, taken from outside the patient's body, without requiring any electronics, wires, etc. for connection to the implant.

Abstract: An ultrasound diagnostic apparatus and a control method of an ultrasound diagnostic apparatus that enable a user to clearly check whether or not a breast of a subject is sufficiently scanned are provided.

Abstract: The multiwavelength ultrasound system includes a first ultrasound device, a second ultrasound device, and a processor. The multiwavelength ultrasound system aggregates and visualizes biological cells. The first ultrasound device is configured to produce a first ultrasound wave having a frequency lower than around 300 kHz. The first ultrasound wave is also configured to aggregate the biological cells. The second ultrasound device is configured to produce a second ultrasound wave having a frequency greater than around 300 kHz. The second ultrasound wave is also configured to visualize the biological cells by determining a location and/or a position of the biological cells. The processor is configured to selectively actuate at least one of the first ultrasound device and the second ultrasound device. The processor is configured to detect at least one of a density and/or a concentration of the biological cells.

Abstract: A system includes a display and a processor a display and a processor. The display is configured to display multiple pixels of an image of an organ having a cavity and tissue surrounding the cavity. The processor is configured to: (1) receive an ultrasound (US) signal of at least the cavity and the tissue and one or more position signals in the organ indicative of one or more positions of one or more catheters having a known geometry, respectively, and (2) based on the one or more position signals, the known geometry, and the US signal: (i) identify in the image a given pixel at a given position, and (ii) display the given pixel as: (a) a first pixel indicative of the cavity responsively to identifying that the given position corresponds to the one or more positions, or (b) a second pixel indicative of the tissue.

Abstract: An ultrasound signal processor uses an excitation generator to cause displacement of a tympanic membrane while a series of ultrasound pulses are applied to the tympanic membrane. Phase differences between a transmitted signal and received signal are examined to determine the movement of the tympanic membrane in response to the applied excitation. An examination of the phase response of the tympanic membrane provides a determination as to whether the fluid type behind the tympanic membrane is one of: no fluid, serum fluid, or purulent fluid.

Abstract: Sold-state intravascular ultrasound (IVUS) imaging devices, systems, and methods are provided. Some embodiments of the present disclosure are particularly directed to compact and efficient circuit architectures and electrical interfaces for an ultrasound transducer array used in a solid-state IVUS system. In one embodiment, an intravascular ultrasound (IVUS) device includes: a flexible elongate member; an ultrasound scanner assembly disposed at a distal portion of the flexible elongate member, the ultrasound scanner assembly including an ultrasound transducer array; an interface coupler disposed at a proximal portion of the flexible elongate member; and a cable disposed within and extending along a length of the flexible elongate member between the ultrasound scanner assembly and the interface coupler. The cable includes four conductors electrically coupling the ultrasound scanner assembly and the interface coupler.

Abstract: An ultrasonic probe is attached to a target to perform ultrasonic measurement. The ultrasonic probe includes: a first substrate including an ultrasonic element array in which a plurality of ultrasonic elements performing at least one of transmission of ultrasonic waves and reception of ultrasonic waves are arranged in an array, the ultrasonic element array being arranged on a first surface of the first substrate; a second substrate facing a second surface opposite to the first surface of the first substrate; and a housing that houses the first substrate and the second substrate therein and is provided with an opening through which the ultrasonic waves pass at a position corresponding to the ultrasonic element array. The second substrate includes a communication unit coupled to the plurality of ultrasonic elements and capable of wirelessly communicating with another terminal device. A weight of the ultrasonic probe is 150 g or less.

Abstract: A mechanical ventilation assistance device includes at least one electronic controller configured to receive positional data of a patient; determine a position of an imaging device configured to obtain imaging data of the patient based on the received positional data; and display, on a display device, a representation of the determined position of the imaging device.

Abstract: A guidance apparatus is provided for use with a portable imaging apparatus and an image display. The guidance apparatus comprises a coupling mechanism which may include a slip ring portion structured for receiving the imaging apparatus therein. The coupling mechanism can be structured for: facilitating orienting the image display device to provide a direct line of sight of an area imaged by the imaging apparatus; adjusting to facilitate rotation of the image display device in at least one 360-degree plane of rotation about a longitudinal axis extending through the imaging apparatus; allowing selection of an image display device position associated with a viewing angle of the image display device; and allowing the coupling mechanism, the image display device, and the imaging apparatus, in combination, to be held in a single hand of a user during performance of an imaging procedure.

Abstract: A rotational intravascular ultrasound probe for insertion into a vasculature and a method of manufacturing the same. The rotational intravascular ultrasound probe comprises an elongate catheter having a flexible body and an elongate transducer shaft disposed within the flexible body. The transducer shaft comprises a proximal end portion, a distal end portion, a drive shaft extending from the proximal end portion to the distal end portion, an ultrasonic transducer disposed near the distal end portion for obtaining a circumferential image through rotation, and a transducer housing molded to the drive shaft and the ultrasonic transducer.

Abstract: A device is provided for automatically assessing functional hemodynamic properties of a patient is provided, the device comprising: a housing; an ultrasound unit coupled to the housing and adapted for adducing ultrasonic waves into the patient at a vessel; a detector adapted to sense signals obtained as a result of adducing ultrasonic waves into the patient at the vessel and to record the; and a processor adapted for receiving the recorded signals as data and transforming the data for output at an interface. Other devices, systems, methods, and/or computer-readable media may be provided in relation to assessing functional hemodynamics of a patient.

Abstract: In an embodiment, an medical device is disclosed. The medical (imaging) device comprises a housing configured for handheld use, a transducer array, a display coupled to the housing, a plurality of sensors distributed about a periphery of the housing and configured to detect when a hand of an operator is positioned around the housing, and a computing device disposed within the housing, wherein the computing device is in communication with the transducer array, the display, and the sensors. The computing device is operable to: monitor the sensors, determine whether a reading from a first sensor at a first edge of the periphery of the housing exceeds a threshold, set the first edge as a primary edge based at least in part on the reading from the first sensor, and orient the display such that the primary edge is at the bottom of the display.

Abstract: An imaging device includes a two dimensional array of piezoelectric elements. Each piezoelectric element includes: a piezoelectric layer; a bottom electrode disposed on a bottom side of the piezoelectric layer and configured to receive a transmit signal during a transmit mode and develop an electrical charge during a receive mode; and a first top electrode disposed on a top side of the piezoelectric layer; and a first conductor, wherein the first top electrodes of a portion of the piezoelectric elements in a first column of the two dimensional array are electrically coupled to the first conductor.

Abstract: An apparatus for processing ultrasound scan data comprises a processor configured to obtain three-dimensional ultrasound scan data for a volume including a region of interest in a subject, the processor is further configured to: provide the three-dimensional ultrasound scan data for display to the user by providing for display to the user a first two-dimensional view of the region of interest in a predetermined direction such that the first two-dimensional view intersects the first boundary; and upon receiving, via the user interface, a user input indicating a location of the first boundary in the first two-dimensional view of the region of interest, generate a second two-dimensional view of the region of interest corresponding to the slice at the first boundary on basis of the indicated location, and providing for display to the user the second two-dimensional view of the region of interest.

Abstract: An ultrasound system includes an ultrasound probe, a user interface device (3) connected to the ultrasound probe by wire, and a mobile information terminal connected to at least one of the ultrasound probe or the user interface device (3), in which the ultrasound probe includes a transducer array, a transmission/reception circuit that generates a sound ray signal based on a reception signal acquired by the transducer array, and a first image generation unit that generates a first ultrasound image based on the sound ray signal, the user interface device (3) includes a second image generation unit (34) that generates a second ultrasound image based on the sound ray signal, and the mobile information terminal includes a monitor that displays the first ultrasound image or the second ultrasound image.

Abstract: A medical image processing apparatus includes a processor configured to execute an image acquisition process for sequentially acquiring time-series medical images; a region-of-interest recognition process for recognizing a position and a type of a region of interest from the medical images; and a display control process for causing a display device to display position information indicating the position of the region of interest and type information indicating the type of the region of interest such that the position information and the type information are superimposed on the medical images. In the display control process, the processor changes a position at which the position information is to be displayed according to a change in the position of the region of interest over time, and maintains a position at which the type information is to be displayed regardless of a change in the position of the region of interest over time.

Abstract: A system and method for human heart modelling to create a dynamic virtual model of heart that can be used for diagnosis and determining suitable therapy. The dynamic virtual model can be created using 2D or 3D echo images or video clips obtained from ultrasound reversal wave data. Arbitrary pixels or voxels in the echo images are tracked phase-by-phase per cardiac cycle. From this, original reversal wave equation ?p attached to the arbitrary pixel or voxel is obtained. Then is generated a deformable map fp with an equation of curve passed from the arbitrary pixel or voxel within the cardiac cycle determined by solving Lagrange-Euler equations. Finally, new 2D or 3D images with improved spatial resolution can be obtained that are used for the human heart modelling.

Abstract: There are provided an ultrasound diagnostic apparatus and a control method of the ultrasound diagnostic apparatus which can obtain a cross-sectional image in which a structure of a lesion part is accurately reproduced.

Abstract: Systems and methods are provided for improving ultrasound image quality. In some embodiments, data sets can be formed from received echoes at each of a plurality of receive elements. The data between the data sets can be masked to include or exclude data. The masked data sets can then be beamformed to form ultrasound images.

Abstract: An ultrasound diagnostic apparatus and a control method of an ultrasound diagnostic apparatus that enable a user to clearly check whether or not a breast of a subject is sufficiently scanned are provided.

Abstract: According to the present invention, in an ultrasound diagnostic apparatus and a control method for an ultrasound diagnostic apparatus, there is provided an ultrasound diagnostic apparatus including an ultrasound probe and an apparatus main body to be connected to the ultrasound probe via wireless communication or wired communication, in which a diagnostic purpose setting section is configured to set a diagnostic purpose input from a user, and a wireless communication determination section is configured to determine whether or not to disable the wireless communication according to a wireless communication status in a case where the diagnostic purpose is a predetermined diagnostic purpose. Then, a wireless communication switching section is configured to set the wireless communication to be disabled in a case where it is determined to disable the wireless communication.

Abstract: According to the present invention, in an ultrasound diagnostic apparatus and a control method for an ultrasound diagnostic apparatus, an ultrasound image generation unit is configured to generate an ultrasound image including an examination area, and an optical camera is configured to generate an optical image including a subject under examination in a state in which an ultrasound probe is in contact. A display control unit is configured to display the ultrasound image and the optical image on a monitor, and a first image memory is configured to store the ultrasound image and the optical image generated in a certain period in a past from a timing designated by a user.

Abstract: According to the present invention, in an ultrasound diagnostic apparatus and a control method for an ultrasound diagnostic apparatus, an ultrasound image generation unit is configured to generate an ultrasound image from a reception signal obtained by transmitting and receiving an ultrasound beam to and from an examination area of a subject under examination using the ultrasound probe, and an optical camera is configured to generate an optical image by imaging the subject under examination including the ultrasound probe during examination of the examination area. A probe recognition section is configured to recognize the ultrasound probe from the optical image, and a trimming section is configured to generate a trimmed image by trimming a region including the ultrasound probe from the optical image in a case where the ultrasound probe is recognized. Then, a display control unit is configured to display the ultrasound image and the trimmed image on a monitor.

Abstract: A process for using temperature measurements to determine health metrics includes: a) using a first temperature sensor of a wearable device to obtain a first set of measurements at a first location on a user's body over a time period; b) using a second temperature sensor of the wearable device to obtain a second set of measurements at a second location on the user's body over the time period; c) processing the measurements to identify changes in temperature over the time period, determining a first health metric based on the changes, and outputting an indication of the first health metric; and d) processing the measurements to compare the temperature at the first location at a given time point to the temperature at the second location at the given time point, determining a second health metric based on the comparison, and outputting an indication of the second health metric.

Abstract: An orally-administered gut sampler traverses the gut and obtains a sample of a bacterial population that is present at a selected location within the gut. The sampler has a body that extends from a proximal end to a distal end along a longitudinal axis thereof. The body includes an inlet at the proximal end and a sample chamber distal to the inlet. A sample of bacteria begins to pass into the inlet and into the sample chamber when the sampler arrives at the selected location.

Abstract: A skin sample collection apparatus comprises a sampling patch having an array of only between 4 and 25 epidermis piercing micro-needles on a face surface thereof, thereby able to yield adequate sample whilst significantly reducing invasiveness (causing pain and discomfort) and reducing the force required for the micro-needles to adequately penetrate the epidermis.

Abstract: Provided herein are devices and methods for ocular fluid collection with minimal eye displacement, decreased risk of injury to structures in the eye and reduced ocular fluid sample loss.

Abstract: Disclosed are puncture sealing systems and methods of locating a puncture site within a vessel. The systems can include puncture locating dilators and access sheaths that are configured to locate the puncture site within a vessel so that the position of the puncture site relative to a distal end of the access sheath is known during a puncture sealing procedure.

Abstract: A suture construct includes a single filament of suture forming two cinchable loops from separate finger trap arrangements, with a fixed-length spanning portion extending between fixed portions of the two finger traps. A tail of the suture extends from each finger trap and is slidably disposed therein to cinch the respective loop. The construct can include an anchor slidably coupled to each of the first and second loops. An inserter for the construct includes first and second insertion devices, each having a proximal handle and distal insertion shaft. The two handles couple together to dispose the insertion shafts alongside each other, with a first shaft extending through the second handle shaft and beyond the second shaft. The first handle is coupled proximal to the second such that the first device can be decoupled from the second by removing it proximally, which withdraws the first shaft from the second handle.

Abstract: A needle (16) for deploying a suture is provided. The needle (16) has a feeding end (11) with an aperture (19) for receiving the suture and a pointed end (3) for creating an incision. The needle (16) extends between the feeding end (11) and the pointed end (3). The needle (16) also has a second aperture (18) and an interior channel (5) extending between the first aperture (19) and the second aperture (18) for transporting the suture from the first aperture (19) to the second aperture (18). A kit for deploying sutures includes at least one suture, at least one needle (16) and at least one pusher (12). The pusher (12) pushes the suture through the interior channel (5) of the needle (16) and out of the second aperture (18).

Abstract: A bone or tissue repair device can deploy first and second anchors from a distal end of a bore of a needle. A cylindrical first anchor can be disposed in the bore proximal to a distal end of the bore. A cylindrical second anchor can be disposed in the bore proximal to the first anchor. A pusher wire can include teeth positioned at a distal end of the pusher wire. The pusher wire and teeth can be configured to engage an interior of the first anchor; advance distally, with respect to the needle, to force the first anchor distally out of the bore; retract proximally, with respect to the needle and the second anchor, to position the teeth inside an interior of the second anchor; engage the interior of the second anchor; and advance distally, with respect to the needle, to force the second anchor distally out of the bore.

Abstract: A first end of a wire is transluminally penetrated through tissue at a first cardiovascular site of a subject. A capture device is transluminally advanced into the subject, and is used to capture the first end of the wire and pull the first end of the wire away from the first cardiovascular site. From the first end of the wire, a first anchor is tracked along the wire, and is then anchored to the tissue at the first cardiovascular site. A second anchor is anchored to tissue at a second cardiovascular site. Subsequently, the first and second cardiovascular sites are drawn together by applying tension between the first and second anchors. Other embodiments are also described.

Abstract: A tissue thickness compensator can comprise a compensator body and at least one vessel contained in the compensator body. The vessel can define an inner cavity which can comprise an inner atmosphere having a pressure which is lower than the atmospheric pressure of the atmosphere surrounding the tissue thickness compensator. In at least one embodiment, the vessel and the compensator body can be maintained in a collapsed state until staples are fired through the vessel. At such point, the vessel can re-expand and apply a biasing force to tissue captured within the staples.

Abstract: A device for attaching a sheet-like implant to a target tissue includes a pilot member and a staple push rod. In some embodiments, the pilot member has a distal end and at least a pair of prongs extending from the distal end. The prongs are configured to form pilot holes when the distal end of the pilot member is pressed against the target tissue. The staple push rod is disposed within at least a portion of the pilot member and slidable relative thereto. The staple push rod includes at least a pair of stakes. Each stake is dimensioned to engage a surface of a staple to apply pushing forces thereto. Each stake is positioned relative to a prong along an inner surface of the pilot member so that the stakes advance into the pilot holes when the stakes are moved in a distal direction. Methods for attaching a sheet-like implant to a target tissue are also disclosed.