Abstract: An end effector for a surgical stapling apparatus is provided which includes an anvil assembly and a surgical buttress. The anvil assembly includes an anvil body and an anvil plate. The anvil plate includes a bottom surface that defines a plurality of staple forming pockets. The anvil body and the anvil plate are selectively connectable. The surgical buttress includes a buttress body and a plurality of arms extending from the body. The arms are disposable between a top surface of the anvil plate and a bottom surface of the anvil body to support the buttress body against the bottom surface of the anvil plate when the anvil plate and the anvil body are connected to one another.

Abstract: A suture placement system is disclosed. The suture placement system has a plate defining a first opening spaced from a second opening. The suture placement system also has a first lumen having proximal and distal ends, wherein the distal end of the first lumen is coupled to the first opening. The suture placement system further has a second lumen having proximal and distal ends, wherein the distal end of the second lumen is coupled to the second opening. The suture placement system also has a guide coupled to the plate. A method of minimally invasive suture placement is also disclosed.

Abstract: Described herein are systems and methods for securing sutures that obviate the need for tying knots. Instead of tying two ends of a suture or two sutures together with a knot, two or more suture portions can be fused or cauterized together using heat. A device can be applied to adjacent suture portions that heats the suture portions and causes the suture portions to fuse together, effectively securing the suture portions together without a knot. Such devices can include a shaft, a heating element positioned within the shaft, and a suture holder at the distal end of the shaft. The holder in an open position receives sutures and in a closed position holds the sutures. Actuation of the device causes the heating element to apply heat and fuse together sutures held by the holder. The holder can separate from the fused sutures after the sutures are fused together.

Abstract: A surgical stapling device includes an elongate member and a loading unit. The loading unit includes a tool portion and a body portion including a first portion having a first length, a second portion having a second length, and a third portion having a third length. The first portion is configured to be releasably secured with the elongate member. The second portion is distal of the first portion and dimensioned to be received in the elongate member. The third portion is distal of the second portion. At least the second or third portion is configured to engage the elongate member in a sealing relation. The second length is greater than the first and third lengths. The third portion of the body portion is dimensioned to be flush with the elongate member when the first and second portions are received in the elongate member.

Abstract: Surgical closure devices, surgical systems, and methods of endoscopically closing tissue tears are disclosed. The surgical closure device includes a housing and a grasping member. The grasping member is configured for movement relative to the housing. The surgical systems include such a surgical closure device and an endoscope including an insertion tube and a cable. The methods of endoscopically closing a tear in a tissue include passing such a surgical closure device through an endoscope to the tear, engaging a portion of tissue on one side of the tear using the grasping member, positioning the receiving section of the housing on another side of the tear, and moving the grasping member toward the receiving section of the housing and position the grasping member and the receiving portion of the housing in a relatively closed relationship, thereby closing the tear in the tissue.

Abstract: Improved medical suturing devices, systems, and methods for maintaining a position and orientation of a suture needle at a fixed location relative to a suturing device. An exemplary device include a clamp having opposing grasping surfaces for grasping the needle at a first location, and a needle contacting surface for contacting the needle at a second location, the second location a distance axially away from the first location so as to inhibit unintended movement of the needle relative to the device, which may include rotation of the needle about the first location and rotation of the needle about its axis. In many embodiments, the device includes a first and second clamp and a mechanism for alternating grasping of the needle between the first and second clamp. The device may also be incorporated into a single-clamp needle grasping device.

Abstract: A surgical stapling apparatus is disclosed which comprises cartridge body and a layer. The layer is implantable against tissue by staples deployed from the cartridge body and deformed by an anvil. The cartridge and the layer comprise co-operating features which reduce relative movement between the cartridge and the layer. Such co-operating features can also releasably retain the layer to the cartridge body. In addition to or in lieu of the above, the anvil and the layer comprise co-operating features which reduce relative movement between the anvil and the layer. Such co-operating features can also releasably retain the layer to the anvil. In certain instances, the layer can be positioned against the anvil, but releasably attached to the cartridge. The layer can comprise buttress material and/or a tissue thickness compensator, for example.

Abstract: A device for cardiac surgery is disclosed. The device for cardiac surgery includes an aortic root retractor frame, an introducer, and one or more suture locking apparatuses. The device for cardiac surgery also includes an actuator for releasing the aortic root retractor frame, as well as a deployment mechanism for fully expanding the aortic root retractor frame. Multiple suture locking apparatuses used for releasable locking and unlocking of suture during a cardiac surgery procedure may be included in the device for cardiac surgery.

Abstract: 2D and 3D cell culture containers formed from blends of poly-L-lactide and poly-D-lactide provide growth surfaces for adherent cells and do not require surface treatment or coating to support mammalian cell growth. The cell culture containers are transparent, heat tolerant, and are environmentally degradable and suitable for composting in landfills.

Abstract: Surgical suturing constructs, suture anchor assemblies, and methods of tissue fixation are disclosed. The suturing construct includes a bumpy suture. A suturing construct may include one or more small loops on a distal end. A suturing construct may include a splice terminating into a tapered portion/region at a proximal end. A bumpy suture of a suturing construct may form a knotless, closed, self-locking loop around tissue.

Abstract: A suture passer comprising: a hollow tube, the hollow tube comprising a distal end, a proximal end, and a lumen extending from the distal end to the proximal end; and a clamping rod slidably received in the lumen of the hollow tube, the clamping rod comprising a distal end and a proximal end, the distal end being bifurcated into a first arm and a second arm, one of the first and second arms extending distally of the other of the first and second arms and including a clamping surface; wherein at least one of the first arm and the second arm comprises a friction-enhancing surface for facilitating manipulation of a suture via engagement of the suture with the friction-enhancing surface.

Abstract: A bone anchor includes a flexible strand defining a first adjustable loop and a friction knot coupled to a proximal end of the first adjustable loop. The friction knot is configured to allow adjustment of the first adjustable loop in a first configuration and is configured to prevent adjustment of the first adjustable loop in a second configuration. A knot capsule includes a body defining an internal knot cavity. The friction knot and a portion of the first adjustable loop are positioned within the internal knot cavity. The internal knot cavity defines one or more impingement surfaces configured to maintain the friction knot in a fixed position within the internal knot cavity when the friction knot is in the second configuration.

Abstract: A surgical suturing apparatus includes an end effector including a jaw assembly and a needle assembly. The jaw assembly includes first and second jaws movable between open and closed positions. Each of the first and second jaws includes a tissue facing surface having an elongated rail and a longitudinal row of teeth. Each tooth of the longitudinal rows of teeth of the first and second jaws includes a needle channel extending therethrough. The elongated rails and the longitudinal rows of teeth of the first and second jaws are disposed in opposed relation relative to each other. The needle assembly includes a first needle, a second needle, and a suture coupled to the first and second needles. The first needle is slidable through the needle channels of the first jaw and the second needle is slidable through the needle channels of the second jaw.

Abstract: Described here are closure devices and methods for ligating tissue, such as the left atrial appendage. The closure devices may comprise a snare loop assembly comprising a snare and a suture loop releasably attached thereto. The snare may be releasable from an elongate body of the closure device. In some instances, the closure device may comprise one or more markers to allow a user to determine whether the snare loop assembly is twisted.

Abstract: Suture clip deployment devices for applying suture clips to sutures are described. Some embodiments can include a generally tubular main body and a vacuum port located at the distal end, a hollow inner body longitudinally slidable within the main body and extending from the main body at its distal end, and a suture recess located in the generally tubular main body. At least one suture clip configured to frictionally fit on an outer surface of the inner body is deployed during use. Clip deployment can occur after a vacuum source is applied to the device so as to draw the suture into the device. The suture lines can be retrieved through the suture recess, and the device can be actuated so as to deliver the suture clip off the delivery device and onto the suture, locking the suture in place.

Abstract: A tool for feeding a fishing line through the eyelets of a fishing rod has a loop of filament attached to an elongated guide and twisted across itself at a distal overlap to form a figure-eight with proximal and distal portions wider and narrower, respectively, than the eyelets. The wider portion facilitates insertion of a free end of the line into the loop. The loop is resiliently flexible so that the overlap separates and then recovers as the inserted line is passed transversely through the gap into the narrower portion of the figure-eight. The passed line is then transversely wedged in the narrower portion of the figure-eight. The loop is also resiliently flexible so that, as the guide leads the loop and the line through each eyelet, the wider portion of the loop compresses and then expands, inhibiting inadvertent withdrawal of the tool from an eyelet.

Abstract: Suturing techniques and sutures capable of reducing the incidence of incisional herniae, including but not limited to subcutaneous surgical sutures performed after laparotomy. Such a suture includes a circular suture having at least first portions that are within a first region of tissue of a suture area that further contains rows of puncture sites aligned approximately parallel to an incision on opposite sides of the incision. The first region of tissue is located between the rows of puncture sites and surrounds the incision, and the first portions of the circular suture extend along the rows of puncture sites. The suture further includes a continuous suture in the suture area that penetrates the puncture sites and traverses the incision. The circular suture disperses stresses induced by tension in the continuous suture to inhibit tearing of tissue at the puncture sites.

Abstract: A suture passer includes a handle assembly, a shaft extending distally from the handle assembly, an end effector assembly coupled to a distal end portion of the shaft, and an overstroke assembly. The overstroke assembly effects an opening and a closing of the end effector assembly while also preventing an overstroke of the handle assembly from damaging components of the suture passer.

Abstract: A rack and an apparatus for suture management are disclosed. The apparatus for suture management includes one or more racks, each rack including a plurality of cassette locations, each cassette location having an inside suture holder, an outside suture holder, and a cassette receiver. The apparatus for suture management also includes a plurality of suture grooves. The apparatus for suture management further includes a plurality of rack connection points. The apparatus for suture management also includes an attachment feature which may accept another surgical tool or mounting adapter.

Abstract: The present disclosure relates to the technical field of medical equipment and discloses an anastomotic/occlusion reinforcing and repairing composite member which includes a reinforcing and repairing portion, a protection portion and a connecting thread, wherein two ends of the reinforcing and repairing portion are detachably connected by the connecting thread; and the protection portion penetrates into a space enclosed by the two ends of the reinforcing and repairing portion. The present disclosure also provides a preparation and application method of the anastomotic/occlusion reinforcing and repairing composite member.

Abstract: A suture-securing device includes a first tubular element, shaped to define a first lumen therethrough, and having first and second ends; and a second tubular element, shaped to define a second lumen therethrough, and having first and second ends. The suture-securing device is configured to have (a) an unlocked configuration in which the first end of the second tubular element is disposed closer to the first end of first tubular element than is the second end of the second tubular element, and the sutures are disposable within and slidable through the first and second lumens, and (b) a locking configuration in which the second end of the second tubular element is disposed closer to the first end of first tubular element than is the first end of the second tubular element, and the sutures are inhibited from sliding through the first and second lumens. Other embodiments are also described.

Abstract: Methods and devices are disclosed that enable safe, rapid and relatively short and straight access to the cerebral arteries for the introduction of interventional devices to treat acute ischemic stroke. In addition, the disclosed methods and devices provide means to securely close the access site to the cerebral arteries to avoid the potentially devastating consequences of a transcervical hematoma.

Abstract: A reduction and fixation tool has two principle component parts—an intra-articular spoon with a blade, and a handle that docks with the spoon. The spoon has a proximal hub onto which the handle docks. In one example of the tool as it would be used with a fractured scaphoid, the spoon has a distal blade, curved and narrow to slip beneath the undersurface of the scaphoid and to lift the distal fragment of the bone back into proper alignment (fracture reduction). The handle, docked to the spoon, serves as a lever to easily accomplish the reduction, and as a guide for the central insertion of a guide wire into the scaphoid across the fracture site.

Abstract: A method of percutaneously creating a fistula includes inserting percutaneously a medical instrument to a target location having a first blood vessel and a second blood vessel. A fastener is then deployed via the medical instrument to the target location. The fastener is in a first configuration before the deploying and a second configuration after the deploying. The fastener limits relative movement between the first blood vessel and the second blood vessel when in the second configuration. An anastomosis between the first blood vessel and the second blood vessel is percutaneously produced.

Abstract: Assemblies and methods suitable for knotless arthroscopic repair of tissue defects include two fixation members coupled by two limbs of suture comprising a continuous loop. A unidirectional restriction element that can be a preformed locking, sliding suture knot proximate to one of the fixation members, provides tensioning of the repair.

Abstract: Described herein are methods and apparatus for approximating targeted tissue using locking sutures. The locking sutures can be configured to receive suture ends that are interweaved through portions of the locking sutures. In a pre-deployment configuration, a locking suture can slide along suture tails and can be positioned at a target location within a target region. Once a desired position and/or tension is achieved, the locking suture can be transitioned to a post-deployment configuration where the locking suture constricts around the suture tails to inhibit relative movement between the suture tails and the locking suture.

Abstract: A surgical stapling apparatus includes an end effector having an anvil assembly and a staple cartridge assembly, and an anvil buttress retention system releasably disposed on the anvil assembly. The anvil buttress retention system includes an anvil buttress and a retention member including an elongated body looped around at least a portion of the anvil buttress with a free end of the elongated body extendable through a looped end of the elongated body in an untightened configuration such that the anvil buttress retention system is slidable relative to the anvil assembly. The free end of the retention member is movable relative to and through the looped end to a tightened configuration to secure the anvil buttress retention system to the anvil assembly.

Abstract: Systems, devices, and methods for soft tissue repair are generally provided and they generally involve the use of surgical filaments that are configured in a variety of manners to minimize and/or eliminate the tying of knots during a surgical procedure. Moreover, systems and devices described herein can provide for a reversible locking knot, which allows for additional tension to be applied to the repair if adjustments are required after the construct has been locked. The reversible locking knot can be “flipped” or actuated without requiring the knot to be untied and then retied. Further, systems and devices described herein can additionally be used to associate implantable bodies and suture constructs within a bone to secure soft tissue while not restricting the relative movements of operative sutures once the implantable body has been deployed.

Abstract: A prosthetic suturing device is disclosed. The prosthetic suturing device has a housing and a needle press slideably engaged with the housing. The prosthetic suturing device also has a plurality of needles coupled to the needle press. The prosthetic suturing device further has a prosthetic retainer. The prosthetic suturing device also has a ferrule platen having a plurality of ferrule holders, each corresponding to one of the plurality of needles. The prosthetic suturing device further has an actuator configured to move the needle press from a retracted position where needle tips of the plurality of needles are away from the ferrule platen to an engaged position where the needle tips of the plurality of needles are at least partially within the ferrule holders of the ferrule platen.

Abstract: An improved method for attaching a sheet-like implant to tissue or bone with a fastener having a first and second arm, and a bridge extending therebetween. Each of the first and second arms include a trunk portion including a longitudinally displaced first and second projections extending in opposite directions within a plane defined by the trunk portions. The method includes forming first and second pilot holes in the tissue or bone using a trocar, receiving the first and second trunk portions within their respective pilot holes, and applying a pullout force on the bridge to create an in-plane torque on each trunk such that the resistance to pullout is increased.

Abstract: The present invention relates to an apparatus (3) for use during implanting at least one medical implant (6) at an implantation site within a patient's body, wherein the apparatus (3) comprises an aligning device (9) for aligning the apparatus (3) at the implantation site, wherein the aligning device (9) is capable of being transferred from a non-aligning position into an aligning position. It further relates to a set and a method.

Abstract: A tendo calcaneus suturing instrument, comprising: a first support and a second support that are of a U-shaped structure, a distance adjustment device, a first guide sleeve, a second guide sleeve, a first positioning tube, a second positioning tube and a tendo sheath cutter. An outer arm and an inner arm of the first support, and an outer arm and an inner arm of the second support are respectively provided with a first positioning hole, a first guide hole, a second positioning hole and a second guide hole; and the first guide sleeve/the second guide sleeve is fixed by means of the first positioning hole/the second positioning hole and is matched with the first guide hole/the second guide hole. The first positioning tube/the second positioning tube provided with a through hole is arranged in the first guide sleeve/the second positioning sleeve or the tendo sheath cutter is arranged in the first guide sleeve and/or the second guide sleeve in a matching manner.

Abstract: Intravascular devices and systems useful for blocking the opening of an aneurysm or a vessel branch are disclosed. In some aspects, the disclosure provides arrangements that align a covering material of a stent graft with an opening in the vessel wall before, during, and/or after expansion of the stent graft within the vasculature of a patient. In some instances, systems and devices include a sheath with a side aperture arranged to align a portion of the sheath and/or a portion of a stent graft contained within the sheath with the mouth of an aneurysm. Similarly, the present disclosure also provides embodiments in which the stent graft comprises an aligning member arranged to align the stent graft and/or a sheath with the mouth of an aneurysm. Other embodiments are disclosed.

Abstract: A fixing device for suturing of blood vessels is provided, which includes a connecting rod, a first clamping member, a second clamping member, a first extension tube and a second extension tube. One end of the first clamping member is disposed on the connecting rod, and the other end of the first clamping member has a first clamping head. One end of the second clamping member is disposed on the connecting rod, and the other end of the second clamping member has a second clamping head. The first extension tube is disposed on an inner side of the first clamping head. The second extension tube is disposed on an inner side of the second clamping head and opposite to the first extension tube, wherein a relative position of the first extension tube and the second extension tube is adjustable.

Abstract: A tissue thickness compensator may generally comprise a first layer comprising a first biocompatible material sealingly enclosed in a water impermeable material and a second layer comprising a second biocompatible material comprising at least one encapsulation, wherein the first biocompatible material expands when contacted with a fluid. The tissue thickness compensator may comprise a haemostatic agent, an anti-inflammatory agent, an antibiotic agent, anti-microbial agent, an anti-adhesion agent, an anti-coagulant agent, a medicament, and/or pharmaceutically active agent. The encapsulation may comprise a biodegradable material to degrade in vivo and/or in situ. The tissue thickness compensator may comprise a hydrogel. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

Abstract: A suturing device includes a needle, a suture, an elongate body, an actuator and a needle holder. The suture connects with the needle. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder includes a distal end section having a distal-most tip, and defines a needle passage for holding the needle and a distal opening. At least a portion of the suture extends through the distal opening when the needle is received in the needle passage and the actuator is in a first operating position. At least a portion of the suture extends along the needle passage toward the distal opening between the needle and an inner surface of the needle holder when the needle is received in the needle passage and the actuator is in the first operating position.

Abstract: A suturing system including apparatus and methods for disposing stitches in a substrate comprising a thread carrier which inserts a thread in the substrate at a first location and withdraws the thread from the substrate at a second location.

Abstract: A surgical port is disclosed. The surgical port has a multi-level flange defining one or more suture channels therethrough. Adjacent levels of the multi-level flange are configured to pinch one or more sutures placed therebetween. The surgical port also has a cannular frame defining one or more cannular channels in communication with the one or more suture channels.

Abstract: A method and apparatus for securing a suture to bone can include grasping a first suture portion with a grasping member on a positioning tool. The first suture portion can be located into a first cannulation defined in the positioning tool. A cutting member can be advanced through a second cannulation defined on the positioning tool and out through a distal opening defined on the positioning tool. A first bone hole can be cut into the bone with the cutting member. A flexible member advancing tool can be advanced through the first cannulation. The first suture portion can be urged out of the distal opening and into the first bone hole.

Abstract: A suture securing assembly comprises a two-bodied anchor and an associated delivery system which enhances fixation of a micro anchor in a bone hole or tunnel, as well as improving suture lock within bone. Initially, the two bodies are separated by a length of an inner shaft of the delivery system. The proximal body is fixed on the inner shaft of the delivery system and cannot move relative to the handle until after insertion into the bone, when the delivery system is disengaged from the anchor. The distal body further includes expansion wings and/or other features for increasing suture lock within the bone hole.

Abstract: A suturing device includes a curved needle, a suture, an elongate body, an actuator and a curved needle holder. The suture connects with the curved needle. The actuator is operable between a first operating position and a second operating position. The curved needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The curved needle holder includes a distal end section having a distal-most tip. The curved needle holder defines a curved needle passage and a distal opening. Movement of the actuator from the first operating position toward the second operating position moves the curved needle with respect to the curved needle holder toward a released condition. The distal end section is configured to allow the curved needle to release from the curved needle holder at a location offset from the distal-most tip.

Abstract: Anchor delivery systems and methods for repairing a valve inside a body, such as an atrioventricular valve, may include an anchor delivery device including a sheath for at least partially retaining an anchor in a collapsed form. The anchor delivery device may be configured to deliver the anchor to the atrioventricular valve. The anchor and an adjacent anchor may be connectable to each other in an expanded form, to link a series of anchors implanted at least partially around the atrioventricular valve. In some embodiments, the anchors may be connectable by a connecting member, such as a pledget, or a material disposable on a bulb of the anchor. In other embodiments, a bulb of the anchor and a bulb of the adjacent anchor may be configured to be directly interlocked.

Abstract: Provided is a digestive-tract treatment method including: pulling, inside a digestive tract (A), an end portion of a first wall portion (A1) positioned at a rim of a treatment target site (B), and moving the first wall portion (A1) to a position on a second wall portion (A2) on an opposite side of the treatment target site (B) from the first wall portion (A1); and joining the first wall portion (A1) and the second wall portion (A2) in a state in which the first wall portion (A1) and the second wall portion (A2) are layered.

Abstract: Surgical constructs, assemblies and methods for tissue reinforcement with a reinforcement (reinforcing) material such as suture, tape, weave, ribbon or mesh, among many others. The reinforced construct includes a reinforced section that prevents a suture from pulling apart. The reinforced section is be a piece of material (a reinforcement or reinforcing material) such as reinforced stitched suture tape attached to a flexible strand. A needle attached to the flexible strand terminating with the reinforced section passes through a proximal end of the reinforced section to form an adjustable “starter loop.” The starter loop is slid and positioned over tissue (for example, graft, tendon, ligament, etc.) and the suture is pulled apart to tighten the loop around the tissue.

Abstract: Embodiments include a method of stapling an anatomical structure of a patient during a minimally invasive procedure, the anatomical structure having a first side and a second side, the method comprising the steps of providing an end effector, the end effector comprising a first jaw having an anvil, a second jaw having a cartridge housing a plurality of staples, providing a buttress, the buttress comprising a first buttress member and a second buttress member, attaching the first buttress member to the anvil, attaching the second buttress member to the cartridge, deploying the plurality of staples, and cutting the first buttress member and the second buttress member.

Abstract: A surgical stapling apparatus includes a jaw assembly including an anvil assembly and a staple cartridge assembly, at least one which includes a surgical buttress retention system, and a surgical buttress releasably secured to a tissue facing surface of the anvil assembly or the staple cartridge assembly via the surgical buttress retention system. The surgical buttress retention system includes proximal guide slots defined in opposed sides of the anvil assembly or the staple cartridge assembly that have a generally U-shaped configuration that are mirror images of each other, a plug coupled to a distal portion of the anvil assembly or the staple cartridge assembly, and a retention member including a central portion extending across a proximal portion of the surgical buttress, second portions positioned within the proximal guide slots, third portions extending across a distal portion of the surgical buttress, and end portions coupled to the plug.

Abstract: A suturing device includes an elongate body, an actuator, a needle holder and a knot pusher. The elongate body includes a proximal end portion and a distal end portion. The actuator interacts with the elongate body and is operable between a first operating position and a second operating position. The needle holder extends away from the distal end portion or is provided as part of the distal end portion of the elongate body, and includes a distal end section having a distal-most tip. The needle holder defines a needle passage and a distal opening adjacent the distal-most tip. The knot pusher connects with and extends away from at least one of the elongate body and the needle holder.

Abstract: Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

Abstract: A penile prosthesis implantation apparatus and related methods are described.

Abstract: A trocar assembly includes a cannula assembly, an obturator assembly, and a catch arm. The cannula assembly has a housing, a cannula, and a working channel defining a longitudinal axis from a proximal opening to a distal opening. The obturator assembly includes a proximal head, a distal tip, and a shaft extending therebetween. The catch arm is selectively moveable from a retracted position to a first and second deployed positions and is configured to releasably capture a suture thread. In the retracted position, the catch arm is positioned radially inward from the first deployed position. In the first deployed position, the catch arm is positioned radially outward from the retracted position. In addition, the catch arm is configured to be moved a predetermined distance from the first deployed position to the second deployed position and release the captured suture thread therefrom.