Abstract: An implantable interbody negative pressure device that permits reduced or negative pressure therapies to be applied to a portion of a patient's body. More specifically, the implantable interbody negative pressure device comprises a body portion having a plurality of openings in fluid communication with both an internal passageway and a vacuum source, and that serves as a manifold and permits reduced or negative pressure therapy to be applied to a surgical site, such as a wound or damaged bone. The application of the reduced or negative pressure to the body improves circulation and the disposal of cellular waste, and promotes bone growth and healing.

Abstract: An apparatus for controlling pressure of a medical gas during treatment of a patient includes is a balloon (1) that through a catheter (2) is introducable into an arterial system of the patient, and a damping bag (20), of greater volume than that of the balloon (1), adapted to be loaded with medical gas at a compliance pressure (Pc) and placed in direct fluid communication with the balloon (1). The damping bag (20) is kept in direct fluid communication with the balloon (1) for the entire duration of the treatment of the patient. The apparatus further includes fine adjusting means (30) for acting on the damping container in such a way that the compliance pressure (Pc) is maintained between the systolic pressure and the diastolic pressure of the patient when the balloon is introduced into the arterial system of the patient and during the treatment of the patient.

Abstract: An ostomy management device (100) including an ostomy port (102) insertable inside a stoma (202) on a patient's abdomen. The ostomy port (102) includes an outer flange (204) placed at periphery of the stoma (202). The outer flange (204) includes a collapsible chamber (210) to collect instilling fluid in a non-operating state of the outer flange (204). A fixation element (208) to anchor the ostomy management device (100) inside an intestine (214). The fixation element (208) is to expand after displacement of the instilling fluid contained in the outer flange (204) to the fixation element (208). An intermediate channel (206) to transport body waste to the stoma (202). A stoma plug (106), attached to the outer flange (204), to cover an opening in the outer flange (204) to stop the body waste from flowing out from the stoma (202) during an operating state of the outer flange (204).

Abstract: A colpotomy system includes a surgical instrument having a cutting element and a receiver at a distal end thereof and a uterine instrument. The uterine instrument has a handle operably coupled to a shaft having a balloon at a distal end thereof, the shaft extending through a retaining member to access a surgical site, the retaining member including a plurality of transmitters for transmitting at least one signal. A distance between the cutting element of the surgical instrument and one end of the retaining member of the uterine instrument is calculated to determine whether the cutting element is within a predetermined operating zone.

Abstract: This disclosure provides tools and implant techniques utilizing such tools to gain access to and implant a medical device, such as a medical electrical lead, within extravascular spaces. In one example, this disclosure provides a tool for creating a sub-sternal tunnel in a patient. The tool comprises a relatively straight guide member extending from a first end thereof to a second end thereof, a tunneling member extending from a first end thereof to a tip thereof, the tunneling member extending alongside and coplanar with the guide member, the first end of the tunneling member and the first end of the guide member being joined together, and a handle coupled to the guide member.

Abstract: A powered or automatic air management system for measuring pressure from an air pressure catheter located within a patient. Powered pumps are included in a remote pump assembly to automatically adjust the air volume to a desired level. A pressure transducer assembly is located at the bed of the patient and is connected to an air catheter, and a separate pump assembly is fixed to an IV pole away from the patient and connected to a pressure monitor to display the pressure readings. By locating the pressure transducer to a location relatively close to the connection point of the catheter, more accurate pressure readings can be achieved.

Abstract: Described embodiments include a method that includes inserting an ablation catheter into a Eustachian tube of a subject, and, using the ablation catheter, while the subject is awake, passing an ablating signal, which is audible to the subject, through epithelial cells that line the Eustachian tube, while controlling an amplitude of the ablating signal responsively to a loudness of the ablating signal as perceived by the subject. Other embodiments are also described.

Abstract: A technology is described for an electronic peripheral nerve stimulation system. The electronic nerve stimulation system can include a stimulation device and an electrode array. The stimulation device can be operable to generate a high-frequency alternating current. The electrode array can be operable to apply the high-frequency alternating current received from the stimulation device to selected subpopulations of peripheral nerve fibers within a peripheral nerve to block transmission of neural signals along the selected subpopulations of peripheral nerve fibers within the peripheral nerve.

Abstract: The invention, in various embodiments, is directed to systems, devices, and methods relating to pre-pubic approaches to delivering a supportive sling to periurethral tissue of a patient. In some embodiments, a system includes a sling assembly having a sling and a sleeve, a guide tube coupled to an end portion of the sleeve, and a delivery device having a shaft, where the shaft can slidably interfit into a lumen of the guide tube such that the distal-most tip of the shaft extends out of the lumen of the guide tube.

Abstract: A urethral plug inserter for insertion a urethral plug into a urethra of a male subject. The device including: a proximal insertion end; a distal gripping end; a central portion disposed between the proximal insertion end and the distal gripping end; and a central channel comprising a floor and axially extending from the proximal insertion end to the distal gripping end and configured to accept a lanyard section of the urethral plug.

Abstract: An orthotopic artificial bladder endoprosthesis includes a casing made of a PGA fiber fabric; the casing having two first connectors for the connection with the ureters of a patient and a further connector for the connection with the urethra of a patient; an inflatable element inserted in the casing; the inflatable element being switchable between an inflated configuration, in which it supports and maintains in position the casing, and a deflated configuration.

Abstract: Systems for providing support to body tissue to alleviate incontinence are disclosed that comprise an elongated incontinence sling having a central support portion adapted to be positioned to support any one of the urethra or anus and first and second sling end portions extending from the central support portion through body tissue and a tension adjustment mechanism acting on or within one or both of the sling end portions. The sling tension adjustment mechanism comprises one or more of a sling tensioning suture or band, a tensioning device coupled to a suture or band free end, a tissue anchor coupled to one or more of a suture free end and a sling end, a mesh fold, a suture tube, and a sling sheath in various combinations.

Abstract: A puncture apparatus is disclosed, which can include an insertion portion that is insertable into a living body, the insertion portion including an urethral insertion portion and a vaginal insertion portion, the urethral insertion portion and the vaginal insertion portion each having at least two sensors; a puncture needle that punctures living body tissues near the insertion portion in a state in which the insertion portion is inserted into the living body, the puncture needle having at least one sensor on a distal portion of the puncture needle; and a monitor configured to receive information relating to a positional relationship between a distal portion of the puncture needle and the insertion portion.

Abstract: An apparatus for treating urinary incontinence, comprising a node; a support section adapted for providing urethral support attached to the node; and, an anchoring section adapted for resisting movement of the apparatus attached to the node; wherein the node is no longer than 30% of the entire length of the apparatus comprising the node, support section and the anchoring section together.

Abstract: An implantable device to treat obesity and a method of using the same, the device (31) is able to create a repetitive mechanical constraint on a gastrointestinal organ wall and includes: an energy source (36), and a mechanical stimulation element (35).

Abstract: Methods and apparatus are provided for treating tissue with apparatus that includes an priming portion for initiating a healing response in the tissue to be treated, and which delivers a bioactive agent during or after preparing tissue adjacent the apparatus, as by generating or aiding a healing, regeneration or repair response in the tissue. The priming portion may comprise an abrasive surface, fluid ejection ports, and/or stimulation by electrical, thermal, or light energy.

Abstract: There is provided a method for controlling a flow of urine in the urinary passageway of a patient's urethra, ureter, renal pelvis or bladder. The method comprises gently constricting (i.e., without substantially hampering the blood circulation in the urinary tissue wall) at least one portion of the urinary tissue wall to influence the flow in the urinary passageway, and stimulating the constricted wall portion to cause contraction of the wall portion to further influence the flow in the urinary passageway. The method can be used for restricting or stopping the flow in the urinary passageway of a urinary incontinent patient, or for actively moving the urine in the urinary passageway, with a low risk of injuring the urethra, ureter, renal pelvis or bladder.

Abstract: Described are pelvic implants (e.g., urinary incontinence sling, hammock, etc.) and method of implanting a pelvic implant that provide treatment for pelvic floor disorders such as incontinence, stress urinary incontinence, prolapse (e.g., cystocele, enterocele, rectocele, vault prolapse), fecal incontinence, and the like, wherein the implant and methods involve various features, such as the ability to adjust dimensions of an implant before, during, or after implantation.

Abstract: A fabricated component for providing desired structural support has plural strands of material extending between opposing gathering points, and free ends extending from the gathering points. The component is preferably fabricated from a single strand of material using an appropriate folding procedure which includes the formation of plural loops of the strand, one upon the other, and development of the gathering points in opposing regions of the looped strand by passing opposing ends of the strand around the loops of the strand, and then through the resulting throws, or using a separate knotting arrangement. The fabricated component can be used in medical procedures, such as the support of subcutaneous tissue, muscle and organs, and other non-medical applications.

Abstract: A urinary incontinence device includes a working portion having an insertion equivalent diameter ranging from about 10 to about 25 mm and a use equivalent diameter ranging from about 25 to about 35 mm under an expansion pressure of about 20 to about 150 cm H2O.

Abstract: An anvil assembly delivery system includes an anvil assembly having a center rod and an anvil head assembly pivotally secured to the center rod a flexible tube having a first end configured for oral insertion into a patient and a second end engaged with the anvil assembly, and a retrieval suture connected to the head assembly positioned to extend from the anvil assembly in a direction opposite to the flexible tube. The anvil assembly delivery system also includes a spacer suture tube positioned adjacent the anvil head assembly and defining a suture channel, which is supported on the retrieval suture and is dimensioned to prevent the retrieval suture from becoming trapped in the staple line of a stapling device. In an embodiment, the spacer is a suture tube defining a suture channel which receives the retrieval suture.

Abstract: A tissue anchor system includes a support, a suture inserted through the support, an anchor having a fin forming an eyelet, where the suture is engaged with the eyelet of the fin. An introducer is provided having a cannula defining a bore sized to receive the anchor and a slot formed in a wall of the cannula, with the slot sized to receive the fin of the anchor.

Abstract: According to an aspect of the disclosure, a treatment method may include treating a wall of a portion of a gastrointestinal tract of a patient. Treating the wall may include positioning one or more injection units adjacent to the wall. Treating the wall may also include affecting at least one of movement of gastrointestinal tract contents through the gastrointestinal tract and absorption of gastrointestinal tract contents by the gastrointestinal tract, by injecting material into the wall using the one or more injection units. Injecting the material may include injecting the material between layers forming at least a portion of the wall.

Abstract: A reflective sample, such as a mask, is imaged in an optics system. A radiation source emits a light beam with relatively low coherence. A first focusing element focuses the beam before a mirror reflects the focused beam towards the sample at an incidence angle of between 2 and 25° A pinhole aperture plate upstream of the sample has a first aperture to focus and cut-off the beam diameter to form a more monochromatic beam. The sample is displaced by a mechanism in a direction perpendicular to the normal vector of the sample surface while it reflects the light beam. The reflected beam passes a second aperture in the pinhole aperture plate next to the first aperture on its way to a pixel detector. The second aperture limits the diameter of the reflected beam, thereby adjusting the diameter of the light beam before it reaches the pixel detector.

Abstract: A medical assembly and method for the delivery of an implant inside a patient's body. The medical assembly includes an implant, a tubular member, and a delivery device. The tubular member includes a proximal portion defining a first locking feature. The delivery device includes a needle having a proximal portion and a handle having a proximal portion and a distal portion coupled to the proximal portion of the needle. The distal portion of the handle also includes a locking member that defines an opening, the opening being configured to allow at least a portion of the tubular member to pass through the locking member when the locking member is in an unlocked configuration and the locking member configured to engage the first locking feature of the tubular member to prevent the tubular member from being removed from the locking member when the locking member is in a locked configuration.

Abstract: Various embodiments of bulking or cushioning agents or material and related medical devices and methods are disclosed. For example, a method of performing a medical procedure in a tract of a body may include injecting a material in a liquid phase proximate a target site between a first tissue layer and a second tissue layer, allowing the material to transition from the liquid phase to the gel phase in response to a raise in temperature of the material to approximately at or above the predetermined temperature, and performing a surgical procedure on the target site. The material may have the liquid phase at temperatures below a predetermined temperature and a gel phase at temperatures approximately at or above the predetermined temperature.

Abstract: A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Abstract: Described are medical graft materials and devices which can be usefully modified with liquid additives such as cell suspensions, bioactive agents, or combinations of these. The medical graft materials and devices can have a first outer surface and a second outer surface and can define an internal chamber between the first outer surface and the second outer surface. The medical graft materials and devices can also have at least one region of the graft material interrupting the chamber and surrounded by the chamber. Also described are methods for making and using these medical graft materials and devices.

Abstract: Various embodiments of sling or implant systems are provided. The sling or implant systems can be employed to treat incontinence, prolapse, and like conditions. A needle delivery device can be included, wherein the delivery device includes a needle and a rotatable sheath. The rotatable sheath can rotate upon actuation relative to the needle to selectively deploy or disengage an implant anchor from the distal end of the needle.

Abstract: A medical implant system for implantation in a patient to treat erectile dysfunction includes a first fluid path, an inflatable penile prosthesis cylinder, an electric pump, and implant controller, and an implantable power supply. The inflatable penile prosthesis cylinder is in fluid communication with the first fluid path and is configured for implantation in a corpus cavernosum of a patient. The electric pump is in fluid communication with the first fluid path. The implant controller is electrically coupled to the pump and is configured to activate the pump to drive a flow of fluid through the first fluid path and into the cylinder. The implantable power supply provides electrical power to the pump.

Abstract: An anvil assembly delivery system includes an anvil assembly having a center rod and an anvil head assembly pivotally secured to the center rod a flexible tube having a first end configured for oral insertion into a patient and a second end engaged with the anvil assembly, and a retrieval suture connected to the head assembly positioned to extend from the anvil assembly in a direction opposite to the flexible tube. The anvil assembly delivery system also includes a spacer suture tube positioned adjacent the anvil head assembly and defining a suture channel, which is supported on the retrieval suture and is dimensioned to prevent the retrieval suture from becoming trapped in the staple line of a stapling device. In an embodiment, the spacer is a suture tube defining a suture channel which receives the retrieval suture.

Abstract: Embodiments of elongate pelvic implants and methods for treating pelvic conditions, such as incontinence, are provided. The implants can include a tissue support portion, one or more extension portions and one or more anchors. The implant is constructed as a unitary sling implant. The implant can be constructed or formed in a generally elongate shape to provide a lattice support structure of repeated cells.

Abstract: A tissue fixation device includes an elongated body extending between a distal portion including a barbed loop, and a proximal portion including a blunt tip. The elongated body, proximal portion, and distal portion are provided in a variety of configurations depending upon the performance requirements desired of the tissue fixation device for the envisaged application of use.

Abstract: An intra-vaginal device for controlling urinary incontinence, designed to be placed longitudinally in the vagina, includes: a. a deformable distal portion, placed in the subvesical region of the vagina, characterized by a deformable state and an un-deformable state; b. a deformable proximal portion placed in the sub-urethral portion of the vagina, characterized by a deformable state and an un-deformable state; c. a deformation controlling mechanism interconnecting said distal portion and said proximal portion, adapted to reversibly transform said distal portion and said proximal portion form said deformable state to said un-deformable state; and from said un-deformable state to said deformable state; wherein upon predetermined amount of intra-vaginal pressure applied on said proximal pressure, said deformation controlling mechanism is adapted to transform proximal portion from said un-deformable state to said deformable state such that pressure is applied on said urethra.

Abstract: In an embodiment, the invention discloses a medical device configured to be delivered and placed within a patient's body. The medical device includes an implant and a cover member. The implant is configured to be disposed within the patient's body. The implant includes a support member, a first arm member and a second arm member, an elongated first sleeve, and an elongated second sleeve. The support member includes a crescent shaped opening.

Abstract: Generally, a vaginal insert device used to treat urinary incontinence is disclosed. The vaginal insert device includes a support portion, a stabilizing portion, a removal device, and at least one fluid passageway extending though the support portion. The substantially cylindrical support portion has a distal end and a proximal end. In addition, the support portion has a plurality of foldable areas extending from the distal end to the proximal end. Desirably, the plurality of foldable areas helically curve as the plurality of foldable areas extend from the distal end to the proximal end. The largest outer circumference of the support portion has an insertion diameter when the plurality of foldable areas are compressed and foldable inward and an in-use diameter wherein the plurality of foldable areas are extended outward into a maximum in-use diameter position. Desirably, the in-use diameter is larger than the insertion diameter.

Abstract: Described are various embodiments of surgical procedures, systems, implants, devices, tools, and methods, useful for treating pelvic conditions in a male or female, the pelvic conditions including incontinence (various forms such as fecal incontinence, stress urinary incontinence, urge incontinence, mixed incontinence, etc.), vaginal prolapse (including various forms such as enterocele, cystocele, rectocele, apical or vault prolapse, uterine descent, etc.), and other conditions caused by muscle and ligament weakness, the devices and tools including devices and tools for anchoring an implant to supportive tissue and adjusting the implant.

Abstract: Various embodiments of an adjustable pessary device are provided. The device can include an elastic ribbon or band, such as Nitinol, encapsulated in a soft or flexible structure, such as a rubber shell. In addition to providing a conforming, comfortable shape, the rubber layer can have additional structures to interface and fit with the anatomical structures within the vagina.

Abstract: A method of placing an implant indwelling in a living body is disclosed. The method can include forming an insertion hole in the living body, the insertion hole extending from a living body surface and passing an obturator foramen on one side and an obturator foramen on the other side, the insertion hole having its end portion on the one side opened in the living body surface and its end portion on the other side closed in relation to the living body surface; inserting a medical tube that permits the implant to be inserted into the medical tube, prior to insertion of the implant; inserting the implant into the medical tube inserted in the insertion hole; and pulling the medical tube out of the insertion hole so that the implant is placed indwelling in the living body.

Abstract: A feeding tube assembly having an improved feeding tube body composed of a tube wall having an external tube surface and an internal tube surface, a proximal end, a distal end separated from the proximal end by a length, and a distal tip region. The internal tube surface defines a feeding passageway extending the proximal end to the distal tip region. The tube body has a first cross-sectional profile from the proximal end to the distal end and at least a second cross-sectional profile from the distal end to the distal tip region. In the first cross-sectional profile, the external tube surface defines an external circumference and the internal tube surface defines a generally non-circular internal perimeter dividing the tube wall into one thin-walled portions and thick-walled portions. In the second cross-section profile, the external tube surface defines an external circumference and the internal tube surface defines an internal circumference.

Abstract: An implant and needle delivery system including a needle selectively releasable from a handle assembly is provided. The needle is selectively connectable with an elongate sling and the needle is selectively releasable from the handle assembly an implantation procedure to treat a pelvic disorder or condition, such as incontinence.

Abstract: In general, this disclosure describes techniques for placing a capsule for sensing one or more parameters of a patient. In particular, the techniques provide for anchoring of the capsule to a tissue at a specific site and releasing the capsule from the device using a single actuator. As an example, a delivery device may anchor the capsule to the tissue site during a first motion of the actuator and release the capsule from the delivery device during a second motion of the actuator. This allows a user to place the capsule by interacting with only a single actuator, thus making delivery of the capsule easier and more reliable.

Abstract: An apparatus for controlling a flow of fluid and/or other bodily matter in a lumen formed by a tissue wall of a patient's organ comprises an implantable constriction device for gently constricting (i.e. without substantially hampering the blood circulation in the tissue wall) at least one portion of the tissue wall to influence the flow in the lumen, and a stimulation device for stimulating the wall portion of the tissue wall. A control device controls the stimulation device to stimulate the wall portion, as the constriction device constricts the wall portion, to cause contraction of the wall portion constricted by the constriction device to further influence the flow in the lumen. The apparatus can be used for restricting or stopping the flow in the lumen, or for actively moving the fluid in the lumen, with a low risk of injuring the organ.

Abstract: In a general aspect, a method of treating urinary incontinence can include slidably interfitting a first push tube into a first dilator tube disposed at an end of a sling assembly and slidably interfitting the first push tube onto an end of a shaft of a delivery device. The method can also include inserting the shaft transvaginally through a vaginal wall and removing the shaft to implant a portion of the sling assembly in periurethral tissue. The method can also include slidably interfitting a second push tube into a second dilator tube disposed at a second end of the sling assembly and slidably interfitting the second push tube onto the end of the shaft. The method can still further include inserting the shaft transvaginally through the vaginal wall and removing the shaft from the patient to implant a second portion of the sling assembly in periurethral tissue.

Abstract: An expansion instrument includes an elongated vaginal-insertion member insertable into the vaginal lumen which is adjacent the urethral lumen with biological tissue interposed between the two, an elongated urethral-insertion member insertable into the urethral lumen, an interlock device interlocking the vaginal-insertion member and the urethral-insertion member to allow the insertion members to be brought closer together and brought farther apart, and a vaginal-side restriction that restricts the positional relationship, with respect to the biological tissue, of the vaginal-insertion member after being inserted into the vaginal lumen.

Abstract: Disclosed is a needle handling device engageable to an introducer tool used for implantation of a penile prosthetic insert in a corpora cavernosum of a penis. The needle handling device includes an attachment section, a needle capturing section and an intermediate section. The attachment section is provided at a first end of the needle handling device and is releasably attached to the introducer tool. The needle capturing section is provided at a second end of the needle handling device and is configured to capture and extract a needle out of the introducer tool. The intermediate section connects the first and the second end of the needle handling device. A method of implanting a penile prosthetic insert in a corpora cavernosum of a penis using a needle handling device is also disclosed.

Abstract: A device is provided for applying pressure on a vaginal wall of a female subject, said device being configured for insertion into a vaginal cavity of said female subject. The device includes a first deformable element, a second deformable element and a transmission element. The first deformable element has a resting-state and at least one deformed state and is configured for undergoing deformation in response to an inner body pressure. When in the resting state, the first deformable element is configured to anchor the device inside the vaginal cavity. The second deformable element has a resting-state and at least one deformed state, and is configured for undergoing deformation to apply a second pressure on the vaginal wall, such second pressure being operable to narrow a urethral portion the female subject.

Abstract: An apparatus (60) for use within a woman's urethra (9) for inhibiting urine outflow when her intra-abdominal pressure rises. The apparatus (60) includes a generally tubular device (50) having a proximal end and a distal end and defining a longitudinal axis. Device (50) comprises structure (5) that is constructed and arranged to define a longitudinal passageway (14) that extends entirely through the device (50) from the proximal end to the distal end. Structure (5) is further constructed and arranged to be altered via an increase in intra-abdominal pressure, from a first state in which the passageway (14) is open along its length and able to conduct urine to a second state in which the passageway (14a) is more restricted or is closed off, to inhibit the passage of urine.

Abstract: An implant for use in a human or animal body can include a flexible housing with an outer wall and having a chamber therein. The implant can have at least one high vapor pressure medium within the chamber. The at least one high vapor pressure medium can have a combined vapor pressure equal to or greater than about the average value of the hydrostatic pressure of the implantation site plus the skin tension of the housing minus the gas tension of the dissolved gasses present at the implantation site.

Abstract: A pessary device having a top, a base, a length, a longitudinal axis, and a hollow interior. The pessary device has a hollow interior containing a protuberance.