Abstract: A method for ligating an internal body tissue using an outer cylinder member and an inner cylinder member including the processes of projecting the inner cylinder from a front end of the outer cylinder member; attaching a ligation band member to an outer peripheral surface of the inner cylinder member; contacting a front end of the inner cylinder member with an internal body tissue; suctioning an inside of the inner cylinder member via a channel communicated with the inside of the inner cylinder member such that the internal body tissue is drawn into the inner cylinder member; and ligating the internal body tissue with the ligation band member by disconnecting the ligation band member from the front end of the inner cylinder member when the inner cylinder member is drawn into the inside the outer cylinder member at a position where the ligation band member is disconnected.

Abstract: A ligating apparatus and method. One embodiment includes a barrel-shaped ligator attached to the penetrating end of a structure, such as an endoscope, and cord pulling assembly at the opposed end of the structure. In the case of use with an endoscope, a pullable cord is wound on the cord pulling assembly and then extends through a working channel in the endoscope to penetrate the ligator. The barrel-shaped ligator is coaxial with the penetrating end of the endoscope, and a practitioner can look through the operating end of the endoscope and see through the endoscope and ligator to observe flesh, for example, in front of the ligating end of the ligator. The ligator includes coaxial inner and outer barrels that rotate with respect to each other upon pulling of the cord by the cord pulling assembly. This relative rotation causes one barrel to move laterally with respect to the other barrel and eject a ligature from the ligating end of the ligator.

Abstract: A device for discharging at least one band onto a tissue is provided. The device includes a housing; a suction assembly coupled to said housing; a dispensing assembly coupled in flow communication to said suction assembly; a discharge assembly coupled in flow communication to said dispensing assembly; and a first manual actuator coupled to said suction assembly and configured to move said suction assembly between a retracted position and an extended position wherein said suction assembly, in said retracted position, is configured to draw the tissue into said discharge assembly.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

Abstract: A new, quick, simple, efficient, safe, and reproducible surgical technique for the treatment of female urinary incontinence, in which the posterior urethra is suspended using a tape passed through the obturator orifices from inside (underneath the urethra) to outside (thigh folds). A variety of specifically designed surgical instruments are utilized to perform this operative procedure.

Abstract: Medical devices useful in the ligation of tissue, apparatuses useful in the making and using of the medical devices, and methods of making and using the medical devices are described. A method of ligating tissue includes placing a ligating band on an introducer, stretching the ligating band, transporting the ligating band to a position adjacent a tissue using the introducer, passing the ligating band over the tissue, and releasing the ligating band from the introducer to place the ligating band in an unstretched configuration around the tissue. A ligating band includes an elongate fiber having first and second ends and forming a series of loops. The second end can be free of direct securement to the first end and secured to a portion of the fiber positioned within a loop of the series of loops.

Abstract: The hemorrhoid ligation apparatus (10) includes a main cylinder (12) to which an O-ring (50) for ligating the hemorrhoid is to be attached on an outer circumferential surface of a front end portion, a sub cylinder (14) air-tightly and slidably provided inside the main cylinder (12), so as to suck the hemorrhoid into the front end portion of the main cylinder (12) upon being drawn toward a rear end portion of the main cylinder (12), an operating fluid loaded inside the sub cylinder (14), and a plunger (16) air-tightly and slidably provided inside the sub cylinder (14), so as to pressurize the operating fluid upon being squeezed toward a front end portion of the sub cylinder (14), to thereby squeeze the O-ring (50) toward the front end portion of the main cylinder (12) with the pressurized operating fluid, thus detaching the O-ring (50) from the main cylinder (12).

Abstract: A variceal banding endoscope includes an elongated shaft having a distal end and a proximal end that is removably connected to a control unit. The endoscope includes a variceal banding apparatus fixedly attached to the distal end of the endoscope and capable of receiving a plurality of ligation bands. A trigger cable extends from the proximal end to the distal end of the shaft and is digitally actuated by an actuator in the control unit or handle of the scope in response to a user input device.

Abstract: A device and method for ligating diseased tissue. The device includes a flexible, substantially tubular sleeve adapted to be positioned around tissue to be ligated and having first and second ends, and at least one anchoring member coupled to the tubular sleeve having an anchoring element positioned substantially adjacent to the first end. The anchoring member has at least one projecting element extending therefrom and adapted to engage healthy tissue when the ligation device is positioned around the tissue to be ligated. The device further includes an elastic element positioned around the periphery of the sleeve and adapted to apply a constrictive force around the periphery of the sleeve.

Abstract: An actuation line is positioned external to the support structure lumen of a medical device. The medical device, which may be a ligation banding cap assembly, may comprise a support structure having a support structure lumen therethrough, an external channel on the outer surface of the support structure, and an actuation line positioned at least in part in the external channel. The external channel may be defined by raised ridges on either side of the external channel. The external channel may be recessed in the outer surface of the support structure. When the medical device is attached to a second elongated medical device, the actuation line is external to the support structure lumen of the medical device and the second elongated medical device.

Abstract: An insert or elongate member divides the lumen of an elongated medical device, such as the working channel of an endoscope, into two or more secondary lumens. The insert or elongate member thereby improves the ability of the lumen of the elongated medical device to accommodate multiple items or uses. The insert or elongate member is capable of securing one item, such as a pull line, such that it does not interfere with another item positioned in the lumen of the elongated medical device or with another use of the lumen of the elongated medical device. In accordance with some embodiments, a ligating instrument comprises a ligating band dispenser, a pull line, and an elongate member having a dividing wall structure or a plurality of lumens, wherein the elongate member divides a working channel of an endoscope into a plurality of secondary lumens.

Abstract: A banding apparatus and method. One embodiment is a unitary or integrated hemorrhoidal single hand-held and single hand-operated ligator, which can, in some embodiments, enable direct visualization and release of multiple bands. The ligator has a gun-shaped handle extending from a vacuum generating trigger tube, with a fixed band bearing barrel extending from the vacuum generating trigger tube. A vacuum generating tube extends through the band bearing barrel from the rear of the gun ligator to the band bearing barrel end of the ligator gun, and is in air movement communication with the vacuum generating tube and band bearing barrel end of the ligator gun. A band actuating barrel is threadably mounted to surround a portion of the band bearing barrel, and rotation of the barrel cause the barrel to move laterally and force one or more ligating bands along and off of the band bearing barrel end. A light source can be included to illuminate the band bearing barrel end.

Abstract: A device for applying successive resilient ligating bands to tissue is described. A sleeve has an opening at a front end thereof, and axially extending arms having axially extending spaces therebetween. Band-support surfaces located on the arms extend from the front end for accommodating a plurality of ligating bands. A first tube around which the sleeve is located, is reciprocal relative to the sleeve and has axially extending fingers provided with forward-facing pushing surfaces. Means are provided for drawing tissue to be ligated into the opening. In use, the pushing surfaces push the bands forwardly so that they ride along the band-support surfaces of the sleeve to each lie nearer the front end, a foremost band being pushed off the front end of the sleeve onto the tissue.

Abstract: An endoscopic assembly for an endoscope is disclosed. The assembly comprises a ligator barrel having proximal and distal portions. The proximal portion has a seat and a receiving wall extending to a proximal end. The receiving wall has a first threaded portion formed thereon. The assembly further comprises a connector for connecting the ligator barrel about the endoscope. The connector has a scope portion and a tip portion. The scope portion has a receiving end through which the endoscope is disposed to engage the seat for connecting the ligator barrel about the endoscope. The tip portion has a second threaded portion formed thereon and are configured to cooperate with the first threaded portion to receive the receiving wall and attach the connector with the ligator barrel. The first and second threaded portions are configured to cooperate with each other to tighten the connection of the ligator barrel about the endoscope as the threads increase surface area contact therebetween.

Abstract: Mounting apparatus for mounting an endless cord (2) which is expandable from a contracted condition to an expanded condition onto an end (1) of a structure having a transverse dimension greater than that of the cord when in the contracted condition comprising a tapered adaptor (14; 114) for the cord to be propelled over onto the end of the structure having a forward smaller end (16; to 116) for location in the cord in its contracted condition and a rear larger end (18; 118) for juxtaposing with the end of the structure and an expander device (24; 124; 224) movable relative to the adaptor to propel the cord over the adaptor onto the rear larger end thereof.

Abstract: The present embodiments provide apparatus and methods for facilitating closure of a bodily opening. In one embodiment, a tissue retraction member and a closure member are provided. The tissue retraction member is advanced in a distal direction through the bodily opening in a contracted state, and then expanded at a location distal to the opening. The tissue retraction member then is proximally retracted to engage first and second serosal tissue regions at least partially surrounding the opening, thereby causing the first and second serosal regions to be disposed in an adjacent relationship. The closure member then is deployed around first and second mucosal tissue regions, such that when deployed, the closure member imposes a compressive force to hold the first serosal tissue region in a sealing relationship against the second serosal tissue region to facilitate sealing of the opening.

Abstract: A surgical introducer for an implant, such as a gastric band. The introducer has a shaft portion with a longitudinal axis extending through proximal and distal sides. A guide bore extends longitudinally through the shaft portion to extend the shaft to slide over an elongated guide member. A band-pulling member is disposed on the distal side and is configured to retain the implant in a loaded position on the shaft and to pull the implant in this position across an incision, such as across an abdominal wall, through an implantation site.

Abstract: A device for elastic ligature of tissues has a first and a second element, one of which exhibits a support portion for at least a rubber ring. The elements are slidably coupled to one another such that a reciprocal sliding between the elements determines a release of a rubber ring from the support portion. A trigger is manually maneuverable by an operator and acts on the second element for realising a reciprocal sliding between the elements. A connecting portion is connected to the trigger and to the second element and is elastically deformable in order to enable a reciprocal change of orientation between the trigger and the second element.

Abstract: A device for elastic ligature of tissues comprises: a first and a second element, one of which exhibits a support portion for at least a rubber ring, the elements being slidably coupled to one another such that a reciprocal sliding between the elements determines a release of a rubber ring from the support portion; a trigger, manually maneuverable by an operator and acting on at least the second element for realizing a reciprocal sliding between the elements; a connecting portion, connected to the trigger and to the second element and being elastically deformable in order to enable a reciprocal change of orientation between the trigger and the second element.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and an elongated axially rigid gripping member extends diametrically across the through-opening. The gripping member can rest on a flange on the opposite side of the through-opening or engage with a second gripping member that extends diametrically across the through-opening from the opposite side of the ring. Or, a flexible cage structure can be disposed in the through-opening.

Abstract: A device, adapted to receive one or more gastric bands and adapted to be coupled to a surgical instrument such as an endoscope, comprises a tubular main body and a cap comprising an opening through which a guidewire may be threaded. A triggering wire may be detachably coupled to one or more bands to permit remote removal of said bands. The bands may be improved bands comprising gripping points, an inner reinforcement ring, or an expanded surface area portion. A method for performing band ligation comprises the steps of: providing a device comprising a main body portion, a removably coupled cap, one or more gastric bands, and a band triggering wire; introducing the device through the mouth into the stomach; dislodging the cap; targeting and drying specific locations of the gastric wall; withdrawing a portion of the gastric wall into the device; and displacing one or more of the bands such that the band circumscribes said wall portion; and the administration of medication to prevent gastric contractions.

Abstract: A ligation tool for endoscope includes an overtube having an insertion lumen 21a made of a flexible material, which permits an insertion portion 11 of the endoscope to be inserted therethrough so as to advance and retreat, an O-ring 22 for ligation attached to a distal end of the overtube, and a operation wire 24 which is locked to the O-ring for ligation, has a distal portion extending to the proximal side of the overtube, and is operated to be pulled or pushed at its proximal side, thereby separating the O-ring for ligation from the tip of the overtube. According to this ligation tool for endoscope, time and effort taken to set the ligation tool for endoscope in the endoscope becomes unnecessary, a sufficient field of vision of the endoscope can be secured, and the curving performance of the tip of the insertion portion of the endoscope does not deteriorate. Furthermore, this ligation tool is also advantageous when endoscopic sclerotherapy is performed together.

Abstract: A cable tensioning apparatus and method are provided for positioning and tensioning a surgical cable to skeletal tissue or to implants. The invention is most applicable for securing surgical cable and/or orthopedic implants to bone in orthopedic surgery. A linearly translated drive rod attached to cable is driven by a friction drive to create tension on the surgical cable.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: An apparatus for delivering a closure element can include a splittable carrier tube and a splitter to split the tube. The carrier tube can have an outer surface retaining a closure element in a tubular configuration and can be split into radially-expandable flaps. A closure element has can have shape-memory body having a relaxed configuration with a planar-annular body defining a lumen with tines directed inwardly from the body. The clip can be held in a retaining configuration having a substantially asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile and a proximal end having the tines being longitudinally directed with a first tine being more distally oriented compared to a substantially opposite second tine being more proximal, and retracting to a deploying configuration having a tubular shape with a rectangular longitudinal cross-sectional profile with the first tine being even with the second tine when being delivered.

Abstract: A variceal banding endoscope includes an elongated shaft having a distal end and a proximal end that is removably connected to a control unit. The endoscope includes a variceal banding apparatus fixedly attached to the distal end of the endoscope and capable of receiving a plurality of ligation bands. A trigger cable extends from the proximal end to the distal end of the shaft and is digitally actuated by an actuator in the control unit or handle of the scope in response to a user input device.

Abstract: A surgical method for removing a port element disposed in an incision or perforation in a wall of a hollow internal organ in a trans-organ surgical procedure. A distal end portion of a tubular member is inserted into the internal organ through a natural body opening. A capture member is ejected from the distal end portion of the tubular member and receives the port element.

Abstract: A device for applying successive resilient ligating bands to tissue is described. A sleeve has an opening at a front end thereof, and axially extending arms having axially extending spaces therebetween. Band-support surfaces located on the arms extend from the front end for accommodating a plurality of ligating bands. A first tube around which the sleeve is located, is reciprocal relative to the sleeve and has axially extending fingers provided with forward-facing pushing surfaces. Means are provided for drawing tissue to be ligated into the opening. In use, the pushing surfaces push the bands forwardly so that they ride along the band-support surfaces of the sleeve to each lie nearer the front end, a foremost band being pushed off the front end of the sleeve onto the tissue.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

Abstract: Disclosed are devices for pericardial access to the heart, including direct access to the left atrium. In certain embodiments, the device may comprise a device and/or an atrial appendage (AA) portal having a configuration such that the distal end of the device and/or the portal can access an atrial appendage while the proximal end of the device and/or portal can extend to outside of the subject. The devices and methods may also include a pericardial portal for emplacement of the device and/or the AA portal. Also, methods for using such devices and/or AA portals and pericardial portals to perform surgery on the heart, and systems (e.g., kits) comprising these devices and/or portals in combination with other therapeutic devices are disclosed.

Abstract: Natural orifice transenteric surgical methods and devices for placing a semi-circumferential appliance around a hollow bodily organ such as the stomach. In one alternative embodiment, such an appliance is placed in order to reduce the inner volume of the stomach.

Abstract: A variceal banding endoscope includes an elongated shaft having a distal end and a proximal end that is removably connected to a control unit. The endoscope includes a variceal banding apparatus fixedly attached to the distal end of the endoscope and capable of receiving a plurality of ligation bands. A trigger cable extends from the proximal end to the distal end of the shaft and is digitally actuated by an actuator in the control unit or handle of the scope in response to a user input device.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

Abstract: The present invention regards an apparatus for selectively and accurately deploying one or more sequentially positioned medical appliances from a portable medical device. The apparatus includes a body having a channel, a string passing through the channel, and a mechanism for moving the string predetermined distances to deploy medical appliances. The medical appliances may be, but are not limited to, ligation bands.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

Abstract: A method and system for determining pressure in a syringe, and more specifically to a syringe pressure accessory which can be connected to a syringe to determine pressure in a syringe and a gastric band. The syringe pressure accessory can detect a pressure of a syringe and/or a gastric band and digitally display the pressure. The syringe pressure accessory can include a durable unit and a disposable unit. The disposable unit can be disposed of after a single use, while the durable unit can be reused with multiple disposable units. The syringe pressure accessory can also include a syringe attachment unit and one or more display units for a caretaker or a patient. The display unit can be wirelessly connected to the syringe attachment unit to display a pressure chart or the results of various analysis of the pressure data. Markers can be added to the pressure chart.

Abstract: The present invention regards an apparatus for selectively and accurately deploying one or more sequentially positioned medical appliances from a portable medical device. The apparatus includes a body having a channel, a string passing through the channel, and a mechanism for moving the string predetermined distances to deploy medical appliances. The medical appliances may be, but are not limited to, ligation bands.

Abstract: A ligature device and method of use are disclosed. More specifically, a ligature device capable of maintaining a ligature band in an elongated position, applying a preformed ligation band to an object to be ligated, manually releasing the ligation band from an elongated position, and securing a ligation band in a tensioned position is described. The ligation device may be used to apply ligation bands to various body parts of various animals.

Abstract: Apparatus and methods are provided comprising an implantable non-hydraulic ring that encircles and provides a controllable degree of constriction to an organ or duct and an external control that powers and controls operation of the ring. The ring includes a rigid dorsal periphery that maintains a constant exterior diameter, and a compliant constriction system that reduces intolerance phenomena. A high precision, energy efficient mechanical actuator is employed that is telemetrically powered and controlled, and maintains the ring at a selected diameter when the device is unpowered, even for extended periods. The actuator provides a reversible degree of constriction of the organ or duct, which is readily ascertainable without the need for radiographic imaging. Methods of use and implantation also are provided.

Abstract: A suturing instrument is configured for to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, trans-vaginal, or endoscopic surgical procedures. The suturing instrument includes an elongate body member, a needle exit port, a needle receiving port, and a needle deployment mechanism. The suturing instrument eliminates the need for a preassembled needle and suture and reduces or eliminates the possibility of needle loss during suturing.

Abstract: A device for elastic ligature of tissues comprises: a first and a second element, one of which exhibits a support portion for at least a rubber ring, the elements being slidably coupled to one another such that a reciprocal sliding between the elements determines a release of a rubber ring from the support portion; a trigger, manually maneuverable by an operator and acting on at least the second element for realizing a reciprocal sliding between the elements; a connecting portion, connected to the trigger and to the second element and being elastically deformable in order to enable a reciprocal change of orientation between the trigger and the second element.

Abstract: A surgical method for removing a port element disposed in an incision or perforation in a wall of a hollow internal organ in a trans-organ surgical procedure. A distal end portion of a tubular member is inserted into the internal organ through a natural body opening. A capture member is ejected from the distal end portion of the tubular member and receives the port element.

Abstract: Described are methods and systems for treating a patient to modify a body passage of the patient. The methods may involve removing tissue from a luminal surface of a body passage such as the esophagus or stomach, for the purpose of inducing a healing response that will result in a reshaping of the body passage.

Abstract: The preferred embodiment of the invention contemplates a device configured to prepare and deploy a resilient sleeve on to a portion of body tissue. The device expands the resilient sleeve, uses a vacuum system to draw the body tissue in to the resilient sleeve, and releases the resilient sleeve from the expanded state so that it captures and constricts the body tissue.

Abstract: Described are methods and systems for treating a patient to modify a body passage of the patient. The methods may involve removing tissue from a luminal surface of a body passage such as the esophagus or stomach, for the purpose of inducing a healing response that will result in a reshaping of the body passage.

Abstract: A surgical instrument for ligating internal tissue of a cavity in the human body by means of an elastic cord is disclosed. The instrument comprises an inner tube, having a distal and a proximal part, with the distal part having a distal end adapted to carry an elastic cord strained around it and with the proximal part arranged to be connected to a vacuum source, wherein at least one tube bend is formed between the distal and proximal part. Further, an outer discharge member is provided to push said elastic cord beyond the distal end of said tube to close around the stem of a tissue when inserted in the tube, the discharge member comprising an outer discharge part displaceably arranged around the distal part, an actuating part displaceably arranged around the proximal part, and a flexible connection part following said tube bend and arranged to transfer a movement of the actuating part to the discharge part.

Abstract: An elastic band ligation device for treatment of hemorrhoids and method of treating hemorrhoidal tissue are provided including a plastic inner tubular member for retaining a stretched elastic band over the front end thereof. The inner tubular member has an arcuate configuration extending along at least a portion of the length thereof for a sufficient distance for insertion into the rectum of a patient. A plunger is provided in the tubular member with a handle to allow the operator to pull the plunger and generate a suction for drawing hemorrhoidal tissue into the inner tubular member through the opening at the front end. A plastic outer tubular pusher sleeve is provided having an arcuate configuration corresponding to the arcuate configuration of the inner tubular member to provide a limited friction fit over the inner tubular member.

Abstract: Medical devices and systems for easily and reliably closing a perforation in tissue. One embodiment of a medical device for use with a scope includes a tubular member having a distal end, an exterior surface and an interior space. A carrier element extends along the exterior surface and around the distal end of the tubular member. An elastic band is positioned on the carrier element around the exterior surface of the tubular member. A staple is positioned within the interior space of a tubular member and includes first and second prongs which are spaced apart and translatable relative to one another. The carrier element is structured to deliver the elastic band beyond the distal end of the tubular member where upon the elastic band contracts and engages the staple to translate the first and second prongs towards each other.

Abstract: The present invention regards an apparatus for selectively and accurately deploying one or more sequentially positioned medical appliances from a portable medical device. The apparatus includes a body having a channel, a string passing through the channel, and a mechanism for moving the string predetermined distances to deploy medical appliances. The medical appliances may be, but are not limited to, ligation bands.

Abstract: The present invention regards an apparatus for selectively and accurately deploying one or more sequentially positioned medical appliances from a portable medical device. The apparatus includes a body having a channel, a string passing through the channel, and a mechanism for moving the string predetermined distances to deploy medical appliances. The medical appliances may be, but are not limited to, ligation bands.