Abstract: A minimally-invasive anastomosis system includes a base that is inserted through an incision is made in the chest of a patient between two adjacent ribs. An anastomosis tool and a sensor are attached to the base. The base is attached to the heart, such as by suction, while allowing substantially unrestricted motion of the heart. The sensor provides a view of a surgical field to a display, such that as the base moves along with the motion of the heart, the view of the surgical field remains substantially steady.

Abstract: A system is described for performing vascular anastomosis without the use of sutures. The system includes a connector comprised of memory material and an incision seal. The connector has one end configured to securely engage a graft vessel and another end with wings and barbs. The wings are configured to securely engage an inner wall of a main vessel and the barbs are configured to lock with the incision seal. Once locked, the incision seal and the connector apply a clamping force that secures the graft vessel with the main vessel.

Abstract: Techniques for sutureless vascular anastomosis are described, including a connector having a tip configured to be inserted into a graft vessel, a body having a tine configured to engage tissue associated with a graft vessel, and a base having a front wing, a rear wing, and a barb, each of the front wing, the rear wing, and the barb being formed integrally with the base using a memory material, wherein the front wing, the rear wing, and the barb deploy at one or more pre-determined angles when a restraining force is removed, the restraining force keeping the front wing, the rear wing, and the barb in substantially axial alignment with the body.

Abstract: Techniques for sutureless vascular anastomosis are described, including a sutureless vascular anastomosis connector configured to couple a graft vessel to a main vessel, including a connector body configured to engage a main vessel when inserted into an opening in a wall of the main vessel, and a wing coupled to the connector body and formed using a memory material, the wing being configured to rotate about a transverse axis of the connector when a restraining force is removed from an exterior surface of the wing.

Abstract: A system is described for performing vascular anastomosis without the use of sutures. The system includes a connector comprised of memory material and an incision seal, The connector has one end configured to securely engage a graft vessel and another end with wings and barbs. The wings are configured to securely engage an inner wall of a main vessel and the barbs are configured to lock with the incision seal, Once locked, the incision seal and the connector apply a clamping force that secures the graft vessel with the main vessel.

Abstract: Techniques for sutureless vascular anastomosis are described, including a connector configured to provide fluid communication between a graft vessel and a main vessel, the connector having tines disposed circumferentially about an outer surface of the connector, a front wing coupled to the base, the front wing having a tine configured to engage an inner surface of the main vessel, and having a hinge coupling the front wing to the connector, and a rear wing coupled to the base, the rear wing having another tine configured to engage the inner surface of the main vessel, and having another hinge coupling the rear wing to the connector.

Abstract: A method for performing a surgical procedure is disclosed which uses an anvil delivery system including an anvil assembly, a flexible tube having a first end portion and a second end portion, and a fitting to deliver the anvil assembly to a desired site. The method includes the steps of cutting a second end portion of the flexible tube, attaching a fitting to the second end portion of the flexible tube which has been cut, inserting the insertion tip into tissue, advancing the insertion tip along with the flexible tube and anvil assembly to the desired site within a patient's body, and removing the flexible tube from the anvil assembly and from the desired site leaving the anvil assembly in a patient's body at the desired site.

Abstract: Techniques for sutureless vascular anastomosis are described, including an incision seal including a base configured to partially house an outer surface of a main vessel, the base being formed using a material that is configured to be penetrated by a barb disposed on a connector the main vessel being secured to the base when the base is at least partially pierced by the barb, an upper lumen configured to guide a graft vessel, and a housing opening configured to receive the graft vessel.

Abstract: A deployment cartridge is provided to insert a coated stent into a junction formed between two 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: 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: Device and method for anastomosis may include a circular stapler with central anvil and multiple circumferentially disposed stapling limbs. A tubular graft may be sleeved on the anvil. The anvil with sleeved graft may be inserted into an end of a dissected aorta to form an overlap. Control actuation may cause the limbs to all substantially simultaneously close and then fire staples respectively into the overlap. The staples may form two generally parallel rows around the overlap with staples of each row being staggered relative to staples of the other row, thereby making a leak-free connection between the tubular graft and the end of the aorta. Control actuation may cause the limbs to open so the anvil may be removed from the end of the aorta, leaving the tubular graft in a leak-free connection with the aorta's end. Exemplary embodiments may allow for generally faster anastomosis than prior art.

Abstract: A device for producing anastomoses between a first hollow organ and a second hollow organ including a sheath and an adhesive applicator that can be positioned next to the sheath in order to apply an adhesive to the adhesive bonding section. A method for producing anastomoses between a first hollow organ and a second hollow organ includes folding the first hollow organ over a sheath, positioning the second hollow organ over the first hollow organ, producing a first connection between the hollow organs by applying a high frequency (RF) voltage, and producing a second connection between the hollow organs by applying a tissue adhesive.

Abstract: Methods and devices are provided for enlarging an anastomosis fistula. In general, a surgical clip is applied to tissue surrounding a strictured anastomosis. The clip will exert a pressure on the engaged tissue that causes ischemic necrosis, and as a result the necrotic tissue and the clip will slough off, leaving an anastomosis with a larger diameter fistula.

Abstract: Sol-gel 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 thermoreversible sol-gel compositions, methods, and kits for joining such non-conjoined lumens, including small lumens typically requiring microsurgical technique.

Abstract: An anastomotic device for use in the joining of a first tubular structure and a second tubular structure is provided. The anastomotic device includes a cylindrical sleeve configured and dimensioned for placement at least partially within the first tubular structure, the cylindrical sleeve defining a bore therethrough; an inverting member configured and dimensioned for placement at least partially within the second tubular structure, the inverting member defining a bore therethrough which is configured and dimensioned to selectively receive the cylindrical sleeve therein; and a constricting member selectively positionable on the inverting member and movable onto the cylindrical sleeve when the cylindrical sleeve is at least partially positioned within the bore of the inverting member.

Abstract: A blood vessel connection for a vessel prosthesis includes a connection part, which may be introduced in sections into an open end of a blood vessel and forms a flow channel from the blood vessel to a vessel prosthesis connected on the connection part. The blood vessel connection has a clamping component wherein the blood vessel may be fastened on the connection part.

Abstract: The present disclosure provides structures and/or gaskets for deposition between adjacent intestinal sections in an anastomosis procedure. The structure possesses at least an inner ring of a first material, and a middle ring of a second material. The first material and the second material include a wound treatment material consisting of at least one of an adhesive, a sealant and/or a medicament. The first material is different from the second material.

Abstract: A system and method for closing a percutaneous vessel puncture at the conclusion of a vascular catheterization procedure includes placement of an intravascular closure device having a radially and axially expandable tubular membrane and a radially expandable anchor at the distal end of the membrane. The closure device is placed, by a delivery catheter extending through the puncture site, with its anchor radially expanded in a location upstream of the puncture site to enable the force of a patient's blood flow to deploy the tubular membrane to a proximally extended configuration closing the puncture from within the vessel.

Abstract: A radical prostatectomy anastomosis device including a cartridge having a plurality of anchors slidably disposed in a plurality of distally angled radial channels formed in the cartridge and a pusher assembly operatively coupled within the cartridge. The pusher assembly being configured and adapted to push each of the plurality of anchors out of the angled radial channels of the radial cartridge. The device further including a fitting removably coupled to a distal end of the cartridge. The fitting including a flange having a plurality of holes formed radially around the flange, wherein each of the plurality of holes includes suture locking means configured and adapted to permit a suture to be drawn distally through each of the plurality of holes and to prevent the sutures from being drawn proximally through each of the plurality of holes. The device further including a plurality of sutures secured to an inner surface of the cartridge.

Abstract: Anastomosis devices, tools and methods of performing angled sutureless anastomosis. Devices provided are adapted to be oriented at an acute angle to a host vessel or organ, thereby orienting a graft to be anastomosed to the host by the same angle. The device maintains the angular orientation as it is compressed to join the graft and host.

Abstract: A reversible vasectomy device includes a first and a second connector piece for attachment to the severed ends of the vas deferens. Each connector piece has an outer vas deferens attaching end, an opposite inner end, and a passage from the outer to the inner end. A midpiece has end portions that are connectable to the inner ends of the connector pieces, a passage in one end portion and a vent from the passage to an exterior surface. When the connector pieces are connected to the end portions, the passage in one of the connector pieces is in fluid communication with the vent, but is not in fluid communication with the passage in the other connector piece.

Abstract: An intragastric implant for obesity treatment is disclosed. The device delays digestion by providing a duodenal sleeve, and may also slows gastric emptying by limiting flow through the pyloric sphincter. The implant includes an elongated axially-compressible duodenal sleeve having a non-tissue-piercing anchor on a proximal end sized to lodge within the duodenal bulb. The anchor may have oppositely-directed anchoring flanges to resists migration in both directions. The sleeve may also have barbed ribs to resist proximal movement back up into the stomach. A method of implant includes collapsing/compressing the device and transorally advancing it through the esophagus to be deployed within the duodenum. A dissolvable jacket may constrain the implant for delivery and naturally dissolve upon implant. Removal of the implant may occur in the reverse.

Abstract: Integrated systems and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device configured to deploy and implant anchor devices for such purposes.

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 graft tube is percutaneously placed inside the lumen of a vessel and attached to the lumen wall by loops of suture material. The short sutures are made in the shape of a loop with a sharp and a blunt end then forced into a plurality of first tunnels located in sections of circular cuffs that are attached to graft tube ends. The short sutures are pushed out the first tunnel by push rods and curve back to their original shape through the adjacent lumen wall and into a plurality of second tunnels where the short sutures are lodged.

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: Apparatus and method for performing surgical anastomotic procedures are disclosed herein. The apparatus for performing the surgical anastomotic procedure includes a tubular sleeve defining an axial lumen therethrough, a positioning tube defining an axial lumen therethrough, an expansion assembly having a tubular body and an expandable tip operatively coupled to a distal end thereof, and an anchoring assembly. The positioning tube is preferably configured and adapted to be slidably received within the axial lumen of the tubular sleeve.

Abstract: A system for auto-anastomosing a region of the body using magnetic members that may be individually delivered to different locations in the body. The magnetic members have a polar alignment that generates an attractive force to compress tissue in the region between them. The tissue in the region necroses as a result of the compressive force such that tissue surrounding the necrosed tissue heals together to form an anastomosis. A cutting member may be coupled to either the first or second magnetic member to create a temporary opening in the tissue.

Abstract: A surgical marker/connector can be provided in the form of a ring made of a fluoroscopic material, including a shape memory alloy such as NITINOL. The ring preferably includes a plurality of small suture attachments in the form of loops that are disposed on the periphery of the ring and which lie in a plane that includes the ring itself. The loops are large enough to receive sutures which, in turn, can be used to connect the ring to a portion of a patient's body, or to connect separate portions of a patient's body to each other using the marker/connector as an intermediate connector. If the ring is made of a shape memory alloy, the ring can be wrapped tightly about an elongate member such as a mandrel, which than can be inserted into the patient's body through a trochar or cannula. After insertion, the ring will change temperature and resume its original configuration where it can be sutured in place as desired.

Abstract: A mounting tool for mounting a flexible ring-shaped part of an anastomotic device on a rigid part of an anstomotic device is provided. The tool comprises a receiving portion (104) in a distal end of the mounting tool for receiving the flexible part thereat and a handle portion (103) proximally of said receiving portion (104). Said receiving portion (104) comprises an elongated tubular sheet element (101), and a tubular displacement element (201), arranged within the sheet element (101) to be longitudinally displaceable in relation to the sheet element (101), such that a shelf (401) is obtained circumferentially of the tubular displacement element (106) and distally of the sheet element (101). The shelf (401) is configured to receive the flexible part. A mounting tool for receiving a flexible ring-shaped part of an anastomotic device on a rigid part of an anstomotic device is also provided.

Abstract: Intra-gastric fastening devices are disclosed herein. Expandable devices that are inserted into the stomach of the patient are maintained within by anchoring or otherwise fixing the expandable devices to the stomach walls. Such expandable devices, like inflatable balloons, have tethering regions for attachment to the one or more fasteners which can be configured to extend at least partially through one or several folds of the patient's stomach wall. The fasteners are thus affixed to the stomach walls by deploying the fasteners and manipulating the tissue walls entirely from the inside of the organ. Such fasteners can be formed in a variety of configurations, e.g., helical, elongate, ring, clamp, and they can be configured to be non-piercing. Alternatively, sutures can be used to wrap around or through a tissue fold for tethering the expandable devices. Non-piercing biased clamps can also be used to tether the device within the stomach.

Abstract: Exemplary embodiments comprise AV fistulas and other anastomotic devices for creating new or reinforcing existing side-branch vessels, and/or bridging neighboring vessels together. An exemplary embodiment may comprise a sidewall port, such as a flanged sidewall port, and/or flow frame design, such as a partially bare, flexible stent or a whisk, for purposes of creating a transmural flow. Another exemplary embodiment may comprise a compliant vessel support to aid in the transition from device to vessel and/or vessel to device, and to promote vessel dilation.

Abstract: Devices, methods, and systems for treating Type-2 Diabetes and/or obesity by facilitating the delivery of under-digested nutrients within the gastro-intestinal tract without substantial tissue removal are disclosed. In one aspect, the gastro-intestinal tract of a patient is modified by a gastro-intestinal treatment device comprising an elongate element configured to extend within the gastro-intestinal tract, a first attachment element and a second attachment element disposed on the elongate element, wherein the first attachment element and the second attachment element are configured to attach to the gastro-intestinal tract such that a portion of the gastro-intestinal tract is compressed between the first and the second attachment elements. The length of the gastro-intestinal tract modified by the device is effectively shortened, and its surface area is reduced.

Abstract: A magnetic coupling for connecting a cannula to the apex of a ventricle comprising a first member having a first orifice, a first magnetic material attached to the first member, a means for attaching a cannula to the first member, a second member having a second orifice, a second magnetic material attached to the second member, a means for attaching the second member to a ventricle, so that when the first magnet is placed in proximity to the second magnet the first member and second member are held substantially concentric by magnetic force to allow for the communication of fluid between the first and second orifices.

Abstract: The instant invention provides compositions and methods for promoting the repair and/or growth of biological tissue, e.g., tubular biological tissue such as nerves. Specifically, the instant invention provides tissue connection devices and tissue repair devices and methods for using these devices.

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: Prosthetic valves and their component parts are described, as are prosthetic valve delivery devices and methods for their use. The prosthetic valves are particularly adapted for use in percutaneous aortic valve replacement procedures. The delivery devices are particularly adapted for use in minimally invasive surgical procedures.

Abstract: A surgical instrument for creating an anastomosis includes a housing, a handle extending from the housing and a fastener support member extending distally from the housing. The fastener support member is configured and dimensioned to releasably support a plurality of surgical fasteners. The instrument further includes a tissue retaining mechanism which is selectively movable from a first position relative to the fastener support member to a second position in closer proximity with the fastener support member such that tissue disposed adjacent to the fastener support member is retained thereagainst. Upon actuation of the handle, a fastener firing mechanism simultaneously deforms the plurality of surgical fasteners to complete the anastomosis.

Abstract: A buttress for use with circular surgical staplers that does not require adhesive to securely fasten the buttress to the stapler. Following cutting and stapling by the circular stapler, the buttress has an adaptive opening through its central region with a diameter smaller than the outer diameter of the stapler anvil. Because of relief features built into the buttress, the stapler anvil may be pulled through the buttress material without causing permanent alteration to the buttress. These relief features may be provided regardless of whether the buttress is made of inelastic or elastic materials. The buttress is generally circular in shape with an outer diameter sized to coincide with the outer diameter of the stapler body staple compression surface and the outer diameter of the anvil compression surface of a circular stapler with which it is used. Prior to surgical use, the buttress is attached to the stapler with disruptable portions extending from outer perimetal areas of the buttress.

Abstract: An implantable device for restricting a cross-sectional area of a cavity formed by a stomach wall includes a member. The member has a first end connected with respect to a first portion of the stomach wall and an opposing second end connected with respect to a second portion of the stomach wall. The member has shape memory properties and is adapted to move the first end towards the second end.

Abstract: A magnet assembly for a magnetic anastamosis device is provide that is minimally invasive, easily and quickly delivered, and is accurately positioned to improve the delivery procedure. The magnet assembly includes an elongated hub and a plurality of magnetic members disposed over the elongated hub. The elongated hub is formed of a resilient or shape memory material, permitting the magnet assembly to be operable between a delivery configuration and a deployed configuration. In this manner, the package width of the magnet assembly is greatly reduced for delivery, thereby permitting delivery over a wire guide as well as through an access device such as a catheter. Associated delivery procedures and medical devices are also provided.

Abstract: Methods and devices for fastening tissue are provided. In one exemplary embodiment, a tissue fastener is provided and includes a male fastening member having a base plate with at least one post extending therefrom and having a tissue-piercing tip. A protective member is coupled to the male fastening member and is movable between an open position in which the tissue-piercing tip is enclosed within the protective member such that the tissue-piercing tip is prevented from penetrating tissue, and a compressed position in which the tissue-piercing tip is exposed to penetrate tissue. A female fastening member is configured to mate to the male fastening member and to engage tissue therebetween.

Abstract: A temporary hemostatic plug apparatus for use in a patient includes a plug structure configured to be placed within a patient's tubular body structure. The plug structure may be configured to be placed in an incision to create a bloodless operating field for a surgeon to operate, for example to perform an anastomosis. This may be done by deploying the plug structure out from within the lumen to create a hemostatic seal around the incision. Once the surgeon has completed the operation, the plug apparatus may be removed from the lumen through the incision, or through any other point of access in the lumen.

Abstract: Viscerotomy closure devices and methods of use close a hole in a bodily organ, such as one created during a natural orifice transgastric surgery procedure. A mesh with a hole in its center and an attached loop of suture having a Roeder knot is mounted on the protruding rod of an end-to-end anastomosis stapler between the anvil and the staple carrying member. The mesh covers the staple receiving slots. When rotated when in contact with tissue, an augur-shaped blade attached to the anvil's exterior self-feeds the tissue through a notch in the anvil's base into the space between the anvil and the staple carrying member. After the stapler is fired to staple the mesh to the tissue and create a viscerotomy, a knot pusher cinches the loop of suture and subsequently tightens the Roeder knot to maintain the cinch.

Abstract: A magnet delivery system for forming an anastomosis that comprises a wire guide; a catheter having a delivery portion for advancement into a intracorporeal space, the delivery portion having a lumen extending at least partially therethrough, and a strand connected to the catheter, whereby the magnet is disposed over the wire guide and distal to the catheter, and retained by the strand being releasably connected to the wire guide.

Abstract: Compression plate apparatus enables vessels to be joined together in various anastomosis configurations. The compression plates are guided to each other in a parallel orientation by guides. The compression plate apparatus may be utilized with an intraluminally directed anvil apparatus or an externally positioned anvil apparatus. One of the compression plates assists in the eversion of the anastomosis fenestra contour. One of the compression plates enables a graft vessel to be pre-everted so that the anastomosis fenestra contours are everted. The apparatus provides a structure that enables the vessels to be joined without being penetrated.

Abstract: Apparatus for performing a surgical anastomosis are disclosed. The apparatus include a tubular body having a proximal end and a distal end, an onion sleeve portion formed near the distal end of the tubular body and an inner tube disposed within the tubular body. The inner tube includes at least one pair of longitudinally aligned needle passages formed below the onion sleeve portion of the tubular body. The apparatus further includes at least one needle assembly disposed within the at least one pair of longitudinally aligned needle passages and a firing assembly operatively coupled to the proximal end of the tubular body. The firing assembly is configured and adapted to eject the pair of needles from the apparatus.

Abstract: An anastomotic device for use in the joining of a first tubular structure and a second tubular structure is provided. The anastomotic device includes a cylindrical sleeve configured and dimensioned for placement at least partially within the first tubular structure, the cylindrical sleeve defining a bore therethrough; an inverting member configured and dimensioned for placement at least partially within the second tubular structure, the inverting member defining a bore therethrough which is configured and dimensioned to selectively receive the cylindrical sleeve therein; and a constricting member selectively positionable on the inverting member and movable onto the cylindrical sleeve when the cylindrical sleeve is at least partially positioned within the bore of the inverting member.

Abstract: Methods and apparatus for delivering and installing a new length of tubing between two sections of a patient's existing body organ tubing and at least partly outside of that existing structure. For example, the new length of tubing may be for the purpose of providing the patient with a coronary bypass. The new tubing may be an artificial graft, a natural graft (harvested elsewhere from the patient), or both. The new tubing is installed at the operative site primarily by providing at least one graft location with instrumentation inserted through the patient's existing tubular body organ structure. Assistance in installing the new tubing may be provided by minimally invasive surgical access openings in the patient's chest. The tubing may be delivered through the patient's existing tubular body structure or, alternatively, through the surgical access openings.

Abstract: Disclosed is an anastomosis catheter, for achieving a tissue to tissue or synthetic graft to tissue attachment. The catheter includes a plurality of deployable tissue anchors, which may be laterally deployed into surrounding tissue. The anchors may be used to achieve end to end or end to side anastomoses. Methods are also disclosed.