Abstract: The present invention is of a method for performing an anastomosis and in particular, to such a method in which an end-to-side vessel endoluminal proximal anastomosis is performed in a minimally invasive CABG procedure.

Abstract: A stapling device for a surgical endoscopic device provided with at least one flexible portion, comprising a staple-firing portion and an anvil portion, wherein one of the staple firing portions and one of the anvil portions are located longitudinally displaced from one another along the longitudinal axis of the endoscopic device, with at least a part of said flexible portion between them. The parts of the stapling device are in correct working relationship when one or more alignment and/or locking pins or screws that are stored in one of the staple firing portions or one of the anvil portions are extended and engage and lock or screw into receptacles that have been provided on the other of the staple firing portion or of the anvil portion.

Abstract: Described here are devices and methods for intussuscepting a portion of stomach tissue. Typically the intussusception is created at a position near, but distal to the gastroesophageal junction, and a pouch capable of storing a volume (from about 0 cc up to about 100 cc) is created proximal the intussuscepted tissue. In this way, the amount of food that may be ingested is reduced, helping to ameliorate GERD symptoms, and aiding in weight loss efforts. Some of the devices described here include an expandable member and at least one suction inlet. In these devices, the expandable member is expanded to create a proximal cavity into which the stomach tissue is pulled (e.g., using suction), thereby creating the intussusception.

Abstract: Devices and methods for tissue acquisition and fixation, or gastroplasty, are described. Generally, the devices of the system may be advanced in a minimally invasive manner within a patient's body to create one or more plications within the hollow body organ. A tissue treatment device attached to a distal end of a flexible elongated member and has a cartridge member opposite an anvil member. The cartridge member and the anvil member are movable between a closed position and an open position relative to one another, and the cartridge member is re-loadable with a removable staple cartridge to form multiple plications within the organ with the same tissue treatment device.

Abstract: An end-to-end joint for joining end zones (2, 3) of body ducts comprises: a first joining member (4) and a second joining member (5) that can be associated with corresponding end zones (2, 3) of the duct to be joined and a connector (6) that can be associated with the two joining member (4, 5) in order to connect them to each other; each of the two joining members (4, 5) comprises a first ring (7) equipped with a plurality of rods (8) positioned along the ring's directrices; a second ring (9) coaxial with the first ring (7) and having a diameter (D9) not greater than the diameter (D7) of the first ring (7); arms (10) each having a first end (10a) connected to the first ring (7) and a second end (10b) connected to the second ring (9) to position the rings (7, 9) at a predetermined axial distance, with the rods (8) of the first ring (7) projecting towards the second ring (9); the arms (10) are plastically deformable from an open position where the rings (7, 9) are at said predetermined axial distance, to a bent

Abstract: A stapling apparatus for performing anastomosis on hollow organs. The apparatus consists of two combinable tools which are L-shaped, one tool for retaining staple retaining clips, and the other tool for retaining staples. The L-shaped tools are each provided with an elongated handle and a C-shaped jaw positioned at a distal bottom end of the handle in a plane substantially transverse to the handles of the tools. When the two tools are combined, the C-shaped jaw retaining a series of staple retaining clips is positioned below the C-shaped jaw retaining the arranged series of staples with the respective staples in registration with respective underlying clips for stapling. The C-shaped jaws provide gaps which permit ingress and egress of hollow organ ends to be stapled.

Abstract: A remote cannulation assembly is disclosed for rapidly cannulating a body part such as a heart during a medical procedure. Cannulation is often conducted in procedures such as the installation of a ventricular assist device. The cannulation assembly of the invention utilizes an isolation valve to create a sealed fluid environment for the procedure. The invention further includes a coring assembly that may be used with the cannulation apparatus. Methods of cannulating a heart or other body part are also disclosed in which the risk of emboli is reduced. Additionally, methods of connecting and disconnecting two fluid conducting elements are disclosed.

Abstract: A method and device for facilitating the anastomotic healing of a patient after a radical prostatectomy surgical procedure, without a urethral catheter, comprising the steps of performing a radical prostatectomy, fixedly positioning a splinting element between the urethra and the bladder, across the urethral opening, placing the splinting element during the performing of the radical prostatectomy and prior to surgical closure. The fixed positioning is effected from a position within the bladder with anchoring the splinting element in position relative to the interior of the bladder, setting a separate urine drainage tube, and removing the splinting element, after anastomotic healing, with a retrieval element on the splinting element or with dissolving of the splinting element.

Abstract: A gastric balloon and method of adding and removing fluid therefrom are disclosed. The gastric balloon includes a shell, a receiver, and a retractable tubing housed in the receiver and extendable from the stomach of a patient to the mouth of the patient. The shell is inflated and deflated from outside the body of the patient. The method of adding or removing fluid from the implanted gastric balloon includes steps of inserting a gastroscopic tool into the stomach of a patient and grasping an end of a retractable tubing housed in a receiver of the gastric balloon. Further steps of the method include withdrawing at least a portion of the retractable tubing from the stomach and out of a patient's mouth and adding or removing fluid from the gastric balloon via the retractable tubing withdrawn from the patient.

Abstract: Methods are disclosed for the formation of arterio-venous fistula creation. Embodiments include a femoral access approach to the creation of an Aorta-caval fistula at the bifurcation of the Aorta and the Inferior Vena Cava; an apparatus for the creation, modification and maintenance of a fistula; and a method of supplying oxygenated blood to the venous circulation of a patient. The devices, systems and methods can be used to treat patients with one or more numerous ailments including chronic obstructive pulmonary disease, congestive heart failure, hypertension, hypotension, respiratory failure, pulmonary arterial hypertension, lung fibrosis and adult respiratory distress syndrome.

Abstract: A seal element for sealing between tissue lumens includes a first material for allowing tissue ingrowth and a second sealant material.

Abstract: The present invention relates to an improved endoscopic tissue apposition device having multiple suction ports. The invention permits multiple folds of tissue to be captured in the suction ports with a single positioning of the device and attached together by a tissue securement mechanism such as a suture, staple or other form of tissue bonding. The improvement reduces the number of intubations required during an endoscopic procedure to suture tissue or join areas of tissue together. The suction ports may be arranged in a variety of configurations on the apposition device to best suit the desired resulting tissue orientation. The inventive tissue apposition device may also incorporate tissue abrasion means to activate the healing process on surfaces of tissue areas that are to be joined by operation of the device to promote a more secure attachment by permanent tissue bonding.

Abstract: A deployment cartridge is provided to insert a coated stent into a junction formed between to tubular tissue sections. The deployment cartridge includes a pusher and a coated stent contained within the pusher. The pusher includes support structure for engagement with the stent. The stent is coated with a tissue sealant or tissue adhesive. An insertion instrument is also disclosed for advancing the deployment cartridge into the junction formed between the two tubular tissue sections. There is also disclosed a method of facilitating the support and healing at a juncture formed between tubular tissue sections with a coated stent.

Abstract: Magnetic compression anastomosis can be carried out by placing cooperating magnets, one in the ileal conduit and one in the ureter, to lock together and form the anastomosis. The magnets may be placed to form a side-to-side anastomosis. At least one of the magnets can include radioactive material. Catheters may be used to place the magnets, and the catheters may have at least one deflatable or retractable tissue spacer.

Abstract: Apparatus and methods for performing a surgical anastomotic procedure are disclosed herein. Apparatus according to the present disclosure include at least one fastener including a first fastener portion having an anchoring leg portion, a second fastener portion including an anchoring leg portion, wherein the first and second fastener portions are operatively associated with one another to selectively fix the position of the first fastener portion relative to the second fastener portion.

Abstract: Methods and devices for partitioning or plicating a region of a hollow body organ are described herein. These methods and devices relate generally to medical apparatus and methods and more particularly to devices and methods for affecting a change in the function of a hollow body organ, particularly a stomach, intestine or gastrointestinal tract. These changes can include reducing the volume capacity of the hollow body organ, disrupting or altering the normal function of the organ, functionally excluding certain sections of the organ either by affixing adjacent tissue or excising certain regions, or affecting or correcting the response of the organ to naturally occurring stimuli, such as ingestion.

Abstract: An intestinal anastomotic surgery aid 1 is constituted with a cylindrical portion 40 for covering the proximal end side of an engaging rod 28, and a cover portion 41 that extends from the cylindrical portion 40 towards the distal end side of the engaging rod 28. The proximal end part of the cylindrical portion 40 is inserted to a recessed portion 26 of a device main body 21 to be held to the device main body 21. The anus-side piece of the intestine is tied with a suture to be held to the outer face of the cylindrical portion 40.

Abstract: A method for treatment of COPD, hypertension, and left ventricular hypertrophy, and chronic hypoxia including creation of an artificial arterio-venous fistula and installation of a flow mediating device proximate the fistula. The flow mediating device is operated to limit flow as medically indicated to provide the optimum amount of bypass flow.

Abstract: An apparatus and method for connecting a first conduit to the heart without the need for cardiopulmonary bypass. The first conduit may then be attached to a second conduit that has a prosthetic device interposed. The second conduit may then be connected to the aorta. The prosthetic device may be a prosthetic valve or a pump, for example. The apparatus of the present invention includes an implantable connector with first conduit component, a retractor expansion component, a coring component, and a pushing component. The retractor expansion component is slide-ably coupled to the coring component. The retractor expansion component serves to seat against and separate the inside apical wall of the left ventricle so that the coring component may cut cleanly through the myocardium to form a tissue plug without leaving any hanging attachments to the inside walls. By remaining seated against the inside wall, the retractor expansion component follows the tissue plug into the coring component.

Abstract: An apparatus comprising a plurality of chambers for receiving an associated plurality of staples, each formed with a shape memory that allows the staple to adopt a straightened configuration, when placed in a stapler, and a deployed configuration for suturing when released from the stapler; and a sleeve moveable relative to the chambers between a first position, in which the staples are trapped by the sleeve within the chambers in the straightened configuration, and a second position, whereby the staples are freed to adopt the deployed configuration, wherein the sleeve is adapted to move between the first and second positions by rotating relative to the chambers.

Abstract: An equipment to approximate tissue portions, which are intended to form an anastomosis comprises a guide means suitable for passing through a first tissue portion (12) and a second tissue portion (14) to be connected by anastomosis. This equipment further comprises an anastomotic device (10) to approximate the first tissue portion (12) and the second tissue portion (14) to be connected by anastomosis. The guide means consists of at least two guide wires (A, B), suitable for passing through the tissue portions to be connected, to receive and drag at least said anastomotic device (10) to approximate the first tissue portion (12) and the second tissue portion (14) to be connected by anastomosis. The guide wires (A, B) are located side by side to each other and are suitable for forming a loop which passes through the tissue portions to be connected.

Abstract: A gastric bariatric balloon includes an upper balloon chamber for sealing against the fundus, a lower balloon chamber for sealing against the antrum and occupying the body of the stomach, and a supplementary chamber for filling at least a portion of the fundus. A tubular inlet is proximal the esophagus entry for receiving a hollow needle. This inlet is filled with a self-sealing material so that when punctured by the needle the material closes the needle hole upon withdrawal of the needle. Spaced apart voids in the material enable fluid interchange between the needle and each of the three chambers separately depending upon the depth of the needle within the inlet tube. Safety arms are mounted on the upper balloon chamber so as to prevent passage of the balloon through the pylorus in case of sudden deflation.

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point. Adjustable anchor assemblies, as well as anchor delivery systems, are also provided.

Abstract: Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly.

Abstract: Disclosed is a conduit that provides a bypass around an occlusion or stenosis in a coronary artery. The conduit is a tube adapted to be positioned in the heart wall to provide a passage for blood to flow between a heart chamber and a coronary artery, at a site distal to the occlusion or stenosis. The conduit has a section of blood vessel attached to its interior lumen which preferably includes at least one naturally occurring one-way valve positioned therein. The valve prevents the backflow of blood from the coronary artery into the heart chamber.

Abstract: Apparatus for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract: Disclosed are compositions, methods, and kits for joining together non-conjoined lumens in a patient's body including vascular lumens. More particularly, in various aspects, this invention provides compositions, methods, and kits for joining such non-conjoined lumens, including small lumens typically requiring microsurgical technique.

Abstract: A system including an implantable fastener for fastening layers of tissue is disclosed. In one embodiment, the fastener includes a proximal anchor member and a distal anchor member each being movable from a reduced profile position to a deployed position. The anchor members are mesh structures capable of moving to the deployed position by reducing the axial spacing between opposite ends of the anchor members. Methods of treating gastroesophageal reflux disease (GERD) are also disclosed. One of the methods includes placing the distal anchor member through a hole formed in the wall of the esophagus and through a hole formed in the gastric wall. The distal anchor member and the proximal anchor member are then placed in their deployed positions to fasten the wall of the esophagus and the gastric wall together between the anchor members.

Abstract: A method and device for controlling the compression of tissue include clamping tissue between a first clamping member and a second clamping member by driving at least one of the clamping members with an electric motor toward a predetermined tissue gap between the clamping members and, during the clamping, monitoring a parameter of the electric motor indicative of a clamping force exerted to the tissue by the clamping members. The method and device include, during the clamping, controlling the electric motor, based on the monitored parameter, to limit the clamping force to a predetermined maximum limit.

Abstract: According to an aspect of the present disclosure, a surgical suture needle assembly is provided including an elongate tube defining a lumen through at least a portion of a length thereof; and a wound treatment material contained within the lumen of the suture structure. The present disclosure further provides for methods of using the surgical suture needle assembly in anastomotic procedures and the like.

Abstract: A modular system for therapy within a gastrointestinal system. The system includes anchoring or attachment functionality embodied in a low-profile implant technology and removable therapy components, which can be reversibly attached to these low-profile implants to accomplish various therapies. This modular design allows the physician to tailor the therapy to the patient's needs. The modular system has the potential to create conduits for diversion and/or restriction of food and organ secretions and to facilitate the treatment of metabolic disorders such as obesity and T2DM.

Abstract: A double or triple zip-tied anastomosis surgery method is provided. The method includes circumferentially fastening a first and a second zip-tie around a tubular organ or a connecting region between two tubular organs, with the first and second zip-ties beside each other; dissecting the tubular organ or the connecting region at a space between the first and second zip-ties, forming a first tubular portion with a first zip-tied end and a second tubular portion with a second zip-tied end; resecting a target segment from the second tubular portion, and centrally fastened the resected end; then rejoining the first and the second tubular portions together using a circular stapler, with staples encircling the first zip-tied end and the centrally fastened resected end; and cutting and removing tissues and zip-tie encircled by the staples to recreate a tubular pathway, with a smooth interface between the two tubular portions.

Abstract: Apparatus and methods for performing an anastomosis. More particularly, the apparatus may be used to perform a single or multiple anastomosis with the ability of maintaining fluid flow (e.g., blood) through the anastomosis vessel according to one aspect of the invention.

Abstract: A combined surgical implement used in stomach reduction surgery and for serving as a template and testing integrity of a newly-formed gastric pouch is disclosed. A primary tube extending into a stomach of a patient carries a balloon inflatable to define a size and shape of a newly formed gastric pouch. Suction is applied through the tube to remove the stomach contents and deflate the stomach around the balloon, after which the gastric pouch is surgically formed. After surgical completion of the pouch, the pouch is tested by pressurizing and the pressure monitored. If a leak is present, the pressure falls and air bubbles in the saline solution surrounding the gastric pouch become evident, immediately indicating a leak in the newly-formed gastric pouch, which then may be repaired to seal the leak.

Abstract: Devices and methods are provided for forming one or more plications in the walls of a body cavity. In particular, endoscopic devices and methods are provided for forming and/or securing endoluminal tissue folds to reduce the volume of the gastric cavity. An end effector that includes a tissue receiving cavity can be delivered to a desired surgical site to allow a tissue fold to be formed within the tissue receiving cavity. A fastener can be used to secure the adjacent layers of tissue that form the tissue fold. The tissue folds can be effective to limit the stomach's capacity and create a feeling of satiety.

Abstract: The present invention involves new interventional methods for reducing gastric volume, and thereby treating obesity. The procedures are generally performed laparoscopically and may generally be described as laparoscopic plication gastroplasty (LPG) in which, after obtaining abdominal access, spaced apart sites on a gastric wall are engaged, approximated and fastened to create one or more tissue folds forming one or more plications projecting into the gastrointestinal space. The serosal tissue may optionally be treated during the procedure to promote the formation of a strong serosa-to-serosa bond that ensures the long-term stability of the tissue plication. These procedures are preferably carried out entirely extragastrically (i.e. without penetrating through the gastrointestinal wall), thereby minimizing the risks of serious complications.

Abstract: Methods and devices for use in tissue approximation and fixation are described herein. The present invention provides, in part, methods and devices for acquiring tissue folds in a circumferential configuration within a hollow body organ, e.g., a stomach, positioning the tissue folds for affixing within a fixation zone of the stomach, preferably to create a pouch or partition below the esophagus, and fastening the tissue folds such that a tissue ring, or stomas, forms excluding the pouch from the greater stomach cavity. The present invention further provides for a liner or bypass conduit which is affixed at a proximal end either to the tissue ring or through some other fastening mechanism. The distal end of the conduit is left either unanchored or anchored within the intestinal tract. This bypass conduit also includes a fluid bypass conduit which allows the stomach and a portion of the intestinal tract to communicate.

Abstract: A system for tissue approximation and fixation is described herein. A device is advanced in a minimally invasive manner within a patient's body to create one or several divisions or plications within a hollow body organ. The system comprises a stapler assembly having a tissue acquisition member and a tissue fixation member. The stapler assembly approximates tissue from within the hollow body organ with the acquisition member and then affixes the approximated tissue with the fixation member. In one method, the system can be used as a secondary procedure to reduce the size of a stoma within the hollow body organ.

Abstract: An anastomosis device that includes a distal end portion is provided. The distal end portion of the catheter can include a stent-like drainage feature to prevent the formation of blood clots and to improve the flow of urine out of the catheter. The device can further include a balloon device having a thickened wall region to prevent puncturing or damage from the catheter tines.

Abstract: An anastomosis device that includes a catheter body is provided. A distal end portion of the catheter can include a spring device to prevent the formation of blood clots and to improve the flow of urine out of the catheter. The device may be used, for example, in performing procedures such as a vesico-urethral anastomosis in association with a radical prostatectomy, or with an end-to-end urethral anastomosis.

Abstract: A gastrointestinal implant device 600 comprises a sleeve 601 for extending into the duodenum and an artificial valve 602 for placement at the pylorus 603 to control flow from the stomach into the duodenal sleeve 601. A support structure for the valve comprises a scaffold 605 to which the valve 602 is mounted and a luminal prosthesis 606. The luminal prosthesis 606 comprises a proximal flare 620 for location at the antrum of the pylorus, a bulbous region 621, and a scaffold receiving region 606.

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: An assembly for joining two vessel segments of a patient comprises a coupler formed of adjoining coupler halves, and a cuff having a large diameter portion and a small diameter portion. Each of the coupler halves includes an aperture for receiving an end of one of the vessel segments. One of the coupler halves comprises a connector element sized and shaped for connection to the other coupler half. The vessel segments are alignable in the respective coupler halves such that a path for fluid flow is formed therebetween upon connection of the coupler halves. The large diameter portion of the cuff is positioned over at least a portion of the coupler, and the small diameter portion of the cuff is positioned over one of the vessel segments. The cuff further includes a probe positioned at the small diameter portion. The probe is positioned within the cuff in a manner such that a signal is receivable therein corresponding to fluid flow through the vessel segment.

Abstract: Such reinforcing medical device for a sutured tissue area, comprising a stapling line and a stapling circle, the device having a ring shape, so as to cover and reinforce the area along the stapling circle, wherein the ring comprises covering and reinforcing side means (4,6) so as to cover and reinforce portions of the stapling line extending beyond the stapling circle.

Abstract: Methods and devices for treating obesity are provided, and more particularly, methods and devices for performing gastric bypasses are disclosed. In one exemplary embodiment a gastric bypass procedure is provided that includes forming a gastro-entero anastomosis between a stomach and an intestine and forming an entero-entero anastomosis between a portion of the intestine distal to the gastro-entero anastomosis and a portion of the intestine proximal to the gastro-entero anastomosis. A surrogate path is formed between the esophagus and the gastro-entero anastomosis to at least partially direct fluid from the esophagus to the intestine by way of the gastro-entero anastomosis, thereby bypassing the stomach. Devices useful in gastric bypass procedures that include anastomotic devices coupled to or integrally formed with a shunt. The devices can include a plurality of tubular bodies that are configured to have an adjustable length.

Abstract: Disclosed are compositions, methods, and kits for joining together non-conjoined lumens in a patient's body including vascular lumens. More particularly, in various aspects, this invention provides compositions, methods, and kits for joining such non-conjoined lumens, including small lumens typically requiring microsurgical technique.

Abstract: Methods and devices for creating a seal in a vessel for performing multiple anastomoses. The device includes an expandable region at the shaft assembly distal end with a sealing membrane that spans the expandable region, and a corresponding clamping member moveable toward the expandable region. Once inserted into the vessel lumen the expandable region is deployed from a first low-profile position into a second expanded position, and positioned at the target site of the anastomoses. Movement of the distal end of the clamping member, which remains located outside the vessel, against the expanded region creates a seal at the target site allowing a blood-free, graft site area that is large enough to accommodate multiples anastomoses.

Abstract: A clip for closing a puncture hole in a blood vessel comprises a ring having a resiliently expandable circumference and a plurality of barbed prongs extending at least approximately in the same direction from one edge of the ring. A device for deploying such a clip is also described.

Abstract: A device for drawing tissues together and creating an anastomosis comprises a main guide wire (66, 86) suitable to receive and draw anastomotic devices (10; 16; 24) in order to draw together portions (A; B) of tissues to be joined by means of anastomosis. The main guide wire (66, 86) is suitable to be shaped like an open ring crossing the portions (A, A?; B, B?) of tissues to be joined by means of anastomosis (66, 86), wherein the ends of the main guide wire (66, 86) are different and distinguishable from each other. The main guide wire (66, 86) has a tubular or hollow structure suitable to house at least one needle for a push or radiofrequency perforation of the tissues.

Abstract: A system for making anastomoses between hollow structures by mechanical means is provided with a device in the shape of an annular or tubular element comprising circumferentially provided means, such as pin-shaped elements, for joining the abutting walls of the hollow structures together. An applicator is intended for moving said annular or tubular element in position and activating the joining means thereof, so as to make the anastomosis. Possibly, intraluminal joining means can be inserted without using an annular or tubular element.