Abstract: A system for endoscopically forming an anastomosis between two naturally adjacent points in the digestive tract. The system utilizes elongate magnetic devices that, when connected across a tissue boundary, necrose tissue until an anastomosis forms and the devices are passed naturally. Despite the elongate shape of the devices, the resulting anastomosis is substantially round. As such, round anastomoses can be formed having increased diameters merely by increasing the lengths of the devices, obviating the need for wider endoscopes.

Abstract: A shunt device for creating a shunt in an atrial septum includes magnets coupled to inner loops of a coil comprising at least two inner loops and two outer loops, with a diameter of each of the inner loops being less than a diameter of the outer loops. The coil is made of a shape memory alloy (SMA) and is adapted to exert a compressive force upon layers of tissue caught between the inner loops of the coil. The magnets are adapted to provide additional compressive force to adjacent inner loops of the coil, thereby further causing the coil to cut through the layers of tissue and create a shunt. The diameter of the resultant shunt is less than the diameter of the outer loops, thereby preventing the outer two loops from passing through the created shunt. At least one end of the coil has a connection means for connecting with a delivery device.

Abstract: Disclosed herein are systems and methods for insertion tools for implanting electrode leads. In one embodiment, an insertion tool comprises a shaft having an outer cannula and an inner cannula. An actuator may be configured to transition the insertion tool between at least three configurations. In a first configuration, the inner cannula and the outer cannula are configured to receive the lead in the shaft. In a second configuration, the inner cannula and the outer cannula are configured to secure the lead in the shaft. In a third configuration, the inner cannula and the outer cannula are configured to cause the lead to separate from the insertion tool and implant in adjacent tissue.

Abstract: A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside the frame. The simulated tissue model is adapted for practicing a number of surgical procedures including but not limited to transanal excisions and transvaginal hysterectomies. Portions of the frame comprises a material adhesively compatible with the material of portions of the simulated tissue model to secure and suspend the simulated tissue model within the frame. The simulated tissue model may also include simulated vasculature configured to loop through apertures in the frame to secure and suspend the simulated tissue model within the frame.

Abstract: An implantable medical device for connecting tissue layers, such as connecting tubular tissues to create an anastomosis, includes a single elongate member and a covering material. The devices provided may also be used for other purposes including, but not limited to, partially or fully occluding openings in tissue, temporarily or permanently holding generally planar layers of tissue together, aneurysm repair, and the like.

Abstract: A device and method for performing anastomosis is described. In one embodiment according to the present invention, the device comprises a ring that has a plurality of pins extending from various locations on the ring. During a procedure, the pins are passed through portions of tissue and the ring is everted or radially flipped inside out to connect the tissues together.

Abstract: A catheter-based device tracks over a guidewire which has been placed from a first blood vessel into a second blood vessel. The distal tip of the catheter is advanced into the second vessel while a proximal member remains in the first vessel. Matching blunt tapered surfaces on each of the distal tip and the proximal member are clamped together, with adjacent walls of each vessel between them, after which a known, controlled pressure is applied between the two surfaces. Heat energy is then applied to the blunt surfaces for approximately 1-30 seconds to weld the walls of the two vessels together. After coaptation of the vessel walls, the heat is increased to then cut through the vessel walls to create a fistula of the desired size.

Abstract: An apparatus for the treatment of acid reflux disease has an implantable movement restriction device adapted to be at least partly invaginated by a patient's stomach fundus wall. A substantial part of the outer surface of the movement restriction device is adapted to rest against the stomach wall without injuring the latter in a position between the patient's diaphragm and at least a portion of the lower part of the invaginated stomach fundus wall, such that movement of the cardiac notch of the patient's stomach the patient's diaphragm is restricted, to thereby prevent the cardia from sliding through the patient's diaphragm opening into the patient's thorax, so as to maintain the supporting pressure against the patient's cardia sphincter muscle exerted from the patient's abdomen. The movement restriction device has a size of at least 125 mm3 and a circumference of at least 15 mm.

Abstract: Disclosed embodiments include apparatuses, systems, and methods for facilitating anastomosis between bodily passages. In an illustrative embodiment, an eversion mechanism is configured to engage a first external surface of a receiving passage adjacent a first opening in the receiving passage in order to create a receiving flange presenting a first interior face. A donor support mechanism is configured to support a donor passage with an opening in an end in an everted position that forms a donor flange presenting a second interior face. The donor support mechanism is further configured to present the second interior face of the donor flange against the first interior face of the receiving flange to present a passage juncture. A suturing mechanism is configured to motivate a filament through a helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage.

Abstract: The present invention relates to a device for endoscopy or endosonography-guided transluminal interventions whereby two luminal structures in the body may be drawn toward each other and a fluid conduit formed in between. The device may have a hollow central member to which is coupled a distal retention member and in one embodiment a proximal retention member. The retention members may each be positioned inside one of the luminal structures and expanded from a first condition to an expanded second condition having an increased radius. The length of the central member may be shortened and its diameter expanded to approximate the two retention members and thereby the luminal structures.

Abstract: Percutaneous access sheaths used to provide access to the vasculature and heart for the introduction of percutaneous ventricular assist devices (pVADs), and to remain in place for the duration of pVAD use. The sheaths include actively closeable seals engageable to seal against the drive lines of the pVADs to minimize blood loss during pVAD use.

Abstract: A medical device is disclosed, which is capable of treating lymphedema and reducing a reoccurrence rate after treatment. The medical device includes a tube member that includes a first end portion connected to a first body lumen L and a second end portion connected to a second body lumen P and a pressure-feeding unit that pressure-feeds a body fluid in the first body lumen to the second body lumen.

Abstract: Methods, apparatuses and systems are described for expandable stent delivery apparatus to cover an access site. The method may include delivering a stent delivery system through an access site, where the stent delivery system comprises a positioning member with a first portion that is rotatable with respect to a second portion, and where the stent is releasably coupled with the first portion of the positioning member. In some cases, the method may further include withdrawing an outer constrainment member from the stent to deploy a proximal portion of the stent within the body lumen and rotating the proximal portion of the stent away from the access site by withdrawing the positioning member proximally and back through the access site. The method may further include covering the access site with the proximal portion of the stent upon fully deploying the proximal portion from the outer constrainment member.

Abstract: Disclosed embodiments include apparatuses, systems, and methods for facilitating surgical anastomosis. In an illustrative embodiment, an apparatus includes a first connector configured to engage an opening of a donor passage. A second connector is configured to engage an opening in a receiving passage. A separator is configured to support the first connector and the second connector and to fix relative positions of the end of the donor passage to edges of the opening in a receiving passage across a gap. The separator is configured to maintain the gap between the first connector and the second connector while multiple loops of a suture are passed through the edge of the opening in the donor passage and the edges of the opening in the receiving passage. The first connector, the second connector, and the separator are further configured to be removed from between adjacent loops of the multiple loops of the suture.

Abstract: Systems and methods to provide end to end stabilization support to the operational catheter and reduce the need to stabilize or push from the lateral wall of the aorta during coronary interventions. This reduces the potential for stroke from plaque breaking off the wall of the aorta during intervention procedures. A support and stabilization wire having one end at the femoral percutaneous access and the second end at a radial percutaneous access is established for end to end stabilization. A bifurcated catheter having a wide lumen for procedural catheters and a narrow lumen for the support wire or catheter is advanced over the support wire to the aortic arch. A procedural catheter and a variety of different shaped guide wires may be deployed from the wide lumen of the bifurcated catheter into the right or left coronary artery to accommodate a range of aortic anatomical considerations during the coronary interventions.

Abstract: A catheter device 10 with a cutting structure or means 16 on the distal portion 14 is disclosed, along with a medical procedure for using the device. The catheter 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: A delivery device can provide sequential delivery of a plurality of intraluminal devices or tacks held in a compressed state on the delivery device. Delivery platforms on the delivery device can hold a tack in a compressed position and be positioned between annular pusher bands that may also be radiopaque markers. The annular pusher bands can be made of wire or sections of material to increase flexibility while remaining radiopacity. A post deployment dilation device can be included. The post deployment dilation device can be a plurality of expansion filaments, a bellows, or a balloon. A tack deployment method can include allowing a self-expanding tack to expand, aligning the post deployment dilation device under the tack, and causing the post deployment dilation device to expand radial to push outward on the tack.

Abstract: A catheter device 10 with a cutting structure or means 16 on the distal portion 14 is disclosed, along with a medical procedure for using the device. The catheter 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: A method of implanting and securing an implantable flow connector in a body of a patient for providing communication of a first space within the body of the patient with a second space within the body of the patient. The method includes providing a flow connector having a lumen having a first orifice and a second orifice, inserting a retention device into the first space within the body, subsequently inserting the flow connector through an opening in the retention device so the second portion of the flow connector extends into the first space within the body and placing the second space within the body over the retention device.

Abstract: A method for dissecting a submucosal layer includes: incising at a tissue portion surrounding an area including a lesion in a gastrointestinal tract; fixing a thread first end to the area including the lesion, the suture thread including a second end having a needle, and barbs arranged along a longitudinal axis between the first and second ends; piercing the needle to a tract wall that faces the area including the lesion and pulls the thread through the tract wall into the gastrointestinal tract; holding a state of lifting at least a portion of the area including the lesion by pulling the needle or the thread, lifting a tract wall at least the portion including the lesion, and engaging the barbs with the tract wall; dissecting the submucosal layer of the gastrointestinal tract in the state of lifting at least the portion of the area including the lesion.

Abstract: An assembly including a positioning tool that includes a probe affixed to a portion of a grasping tool, wherein a distal tip of the probe protrudes distally from the grasping tool a distance corresponding to a position for placing a magnet with the grasping tool.

Abstract: A sleeve for enforcing the end of a hollow organ so that it can be connected with a further end of a hollow organ, the sleeve comprising a cylindrical shape and being configured to be pushed over the end of the hollow organ and for turning-over the end of the hollow organ projecting from the sleeve around an end of the sleeve, wherein the sleeve has an adjustable diameter.

Abstract: A stent insertion device for connecting human digestive organs includes a first handle being connected to one side of an outer tube, the first handle including a first inner passage communicating with the outer tube, a second handle being connected to a first side of an inner tube, the second handle including a second inner passage communicating with the inner tube, wherein a mounting space is provided between the outer tube and the inner tube at a second side of the inner tube, a stent for connecting human digestive organs being compressed and mounted to the mounting space, a third handle being connected to a first side of an insulation tube, the third handle including a third inner passage communicating with the insulation tube, and a needle knife being connected to a second side of the insulation tube.

Abstract: A medical apparatus for joining body lumens in a living body includes a puncture member having a lumen, a distal opening portion and a needle tip at the distal end of the lumen. The needle tip can puncture a tube wall of the body lumen to form a puncture site. The medical apparatus includes a tubular member in the lumen of the puncture member that expands radially outward and contracts radially inward and a plunger movable relative to the puncture member to release the tubular member from the distal opening portion of the puncture member. The tubular member expands to be fixed to the puncture site when the tubular member is released from the distal opening portion of the puncture member.

Abstract: An everter device to facilitate preparation of ends of arterial segments for end-to-end microvascular anastomosis. The device includes structure that provides sufficient support to prevent unwanted buckling of arterial tissue. The everter device offsets the tendency of the arterial tissue wall to recover its natural shape and fall off securement posts or pins of a coupler ring. The structure may be in the form of an intraluminal catheter balloon. Alternately, the structure may be in the form of a plunger. Alternately, the structure may be in the form of a radially expanding member provided on a shaft. The device further has a contoured surface on an everter end to evert a free end of arterial tissue over a coupler ring, and to cause the posts or pins of the coupler ring to pierce through the everted arterial tissue. The everter end is provided with one or more openings therein, such as a circumferential slot, to receive the posts or pins of the coupler ring.

Abstract: Examples of a stent are provided with interlocking joints removably coupling adjacent axial stent segments. Mating elements forming the interlocking joints maintain engagement when the stent is in the radially compressed configuration, for example, during tracking of the stent to a treatment site of a body vessel, and become disengaged during radial expansion of the stent. When disengaged, the disconnected the axial stent segments remain discrete stent structures separated from one another along the point of treatment.

Abstract: A medical implant that includes a scaffold having at least one receptacle for an X-ray marker. The scaffold includes a first metal. At least one (preferably monolithic) X-ray marker is disposed in the receptacle. The X-ray marker includes a second metal. An electrically insulating coating is upon the X-ray marker to prevent corrosion-promoting contact between the X-ray marker and the scaffold.

Abstract: The invention is an implantable magnetic anastomosis device having an exoskeleton that directs self-assembly. The design allows the device to be delivered in a linear configuration using a minimally-invasive technique, such as endoscopy or laparoscopy, whereupon the device self-assembles into, e.g., a polygon. A coupled set of polygons define a circumscribed tissue that can be perforated, or the tissue can be allowed to naturally necrose and perforate. The device can be used to create anastomoses in a variety of tissues, such as tissues found in the gastrointestinal, renal/urinary, and reproductive tracts. New procedures for using anastomoses, e.g., surgical bypass are also disclosed.

Abstract: Apparatus, systems, and methods are provided for repairing heart valves through percutaneous transcatheter delivery and fixation of annuloplasty rings to heart valves via a trans-apical approach to accessing the heart. A guiding sheath may be introduced into a ventricle of the heart through an access site at an apex of the heart. A distal end of the guiding sheath can be positioned retrograde through the target valve. An annuloplasty ring arranged in a compressed delivery geometry is advanced through the guiding sheath and into a distal portion of the guiding sheath positioned within the atrium of the heart. The distal end of the guiding sheath is retracted, thereby exposing the annuloplasty ring. The annuloplasty ring may be expanded from the delivery geometry to an operable geometry. Anchors on the annuloplasty ring may be deployed to press into and engage tissue of the annulus of the target valve.

Abstract: An occluding device for occlusion of fluid flow through a lumen of a body vessel is manufactured by wedging fibers between adjacent coil windings of a primary coil so that the fibers extend generally radially across the primary coil body between the primary coil windings and outward therefrom. An elongated adhesive applicator is inserted into the primary coil lumen and subsequently proximally withdrawn while simultaneously depositing along the primary coil windings. The fibers and the adhesive are placed in overlapping locations so that the fibers extend through the adhesive. The fibers are thus blocked from slipping along their length relative to the coil body by the adhesive adhering to the fibers inside the primary coil lumen. The adhesive extends radially outward from the coil lumen no farther than the outer primary coil radius. The adhesive adheres to the fibers and may or may not adhere with the primary coil windings.

Abstract: Methods and apparatus for a percutaneous bypass graft system according to various aspects of the present technology include a graft section comprising a dual-sided fixation system at the anastomosis site and a tamper sheath configured to provide enhanced control during installation. The dual-sided fixation system may comprise a plurality of barbs configured to secure the graft section to an internal and external portion of a target vessel. The tamper sheath comprises a cuff at a distal end that is configured to be positioned against an outer surface of the target vessel during the percutaneous procedure.

Abstract: An intramedullary autograft harvesting instrument (100) includes a cutting rod (10) having a body (13) and a cutting head (14), a harvesting member (20) configured to be disposed about the body (13) of the cutting rod (10), and an outer tube (30) configured to be disposed about the harvesting member (20). A method of using the instrument (100) transports harvested tissue from an intramedullary canal.

Abstract: A tissue lumen stent is provided with a body having an elongated tubular configuration and a foreshortened configuration. In the foreshortened configuration, downstream and upstream ends of the body expand radially into downstream and upstream flange structures, leaving a generally cylindrical saddle region therebetween. In some embodiments, the flange structures are non-symmetrical with respect to one another. Systems and methods of using the stents are also disclosed.

Abstract: A tissue anchor includes a plate having a top surface and a bottom surface, and an array of first pins coupled with the plate, whereby each first pin includes an elongated shaft having a lower end with a first barb facing away from the bottom surface of the plate. The plate has an array of second pin apertures that are offset from the first pins, whereby each second pin aperture has a diameter that extends from the top surface to the bottom surface of the plate. The tissue anchor includes an array of second pins extending through the second pin apertures, whereby each second pin has an elongated shaft having an upper end including a second barb facing away from the top surface of the plate and a lower end including a stop that is located below the bottom surface of the plate. The elongated shafts of the second pins have outer diameters that are smaller than the diameters of the second pin apertures for allowing the elongated shafts of the second pins to slide within the second pin apertures.

Abstract: A blood vessel connecting apparatus connects a first blood vessel to a second blood vessel. The blood vessel connecting apparatus includes an elastic connection part and a fixing part. The elastic connection part has an elastic restoring force, is inserted in an end of the second blood vessel and extends along an extending direction of the second blood vessel. The fixing part fixes the elastic connection part to an inside of the second blood vessel.

Abstract: A device for anastomosis of a tubular structure comprises first and second hollow members having a rigid part and an elastic part, and a connection member for interlocking the first and second members. The elastic parts are essentially circular rings, and are made of a polymeric, a biocompatible and/or biodegradable material. The rigid parts have an outer surface that is partly semi-circular in cross section, wherein the diameter at a non-connecting end is larger than or equal to the diameter at a connecting end, which ends in an edge. The first and second members are connected to each other so that a distance is formed between the elastic parts. A cavity is formed between the rigid parts and the connection member and the tubular structure, when arranged in the device.

Abstract: An anastomosis suturing device includes a dismantable casing, a first tubular section having a proximal section encased in the casing and a distal section insertable in a tubular body of a living creature, and a second tubular section having a proximal section encased in the casing and a distal section insertable in a tubular body of the living creature.

Abstract: A uniportal surgical device having a slotted clear cannula, a blade and a housing, wherein the cannula is attached to the housing, and wherein the blade is enclosed in the housing and is slidable into the cannula is disclosed. The device further has a device for locking a viewing device in place relative to other components of the device. A method for a performing an operative procedure on a target tissue in a subject using the uniportal surgical device is also described.

Abstract: The present invention relates to an anastomosis system for realizing anastomosis between first and second hollow structures, such as end-to-side anastomosis, by way of a joining member and an applicator. The anastomosis system comprises an annular joining member adapted for joining the first and second hollow structures, a tubular member adapted to position the joining member at or proximate to a distal end of the second hollow structure and to be at least partially inserted into the second hollow structure, a support member adapted to hold the second hollow structure and a mechanism, for actuating the joining member when positioned at or proximate to the distal end of the second hollow structure, which joining member is actuated substantially radially relative to a longitudinal axis of the tubular member.

Abstract: A vessel implant for the treatment of an aneurysm, i.e. a dilatation of the cross-sectional area of a blood vessel, may include an elongate body having an inlet opening, an outlet opening, and a passage connecting the inlet opening to the outlet opening for the blood flowing through the blood vessel. The passage may be bounded in the peripheral direction by a blood-impermeable wall and the inlet opening may have a larger cross-sectional area than the outlet opening. The body may be provided with blood-permeable fixing means for the end of the body at the outlet opening side. The fixing means may be designed for contact with the vessel wall of the blood vessel. The fixing means may be designed to hold the body spaced apart from the vessel wall of the blood vessel in the region of the outlet opening.

Abstract: An intraluminar method of treating a reflux disease in a patient by implanting a device comprising a non-encircling implantable movement restriction device that, when implanted in a patient, restricts the movement of the cardiac notch in relation to the diaphragm muscle, preventing the cardia from sliding through the esophageal hiatus. The intraluminar method comprises introducing an instrument through the esophagus and into the stomach of the patient, introducing the non-encircling implantable movement restriction device through the esophagus using said instrument, affixing the non-encircling movement restriction device to the fundus wall, such that it does not encircle the esophagus or stomach, thereby preventing the cardia from sliding through the esophageal hiatus and thus reducing reflux disease without encircling the esophagus or stomach.

Abstract: A catheter device with a cutting structure or means on the distal portion is disclosed, along with a medical procedure for using the device. The catheter is utilized in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: The method for producing a three-dimensional artificial tissue is a method in which a three-dimensional artificial tissue extending in a predetermined direction is produced. The method includes: preparing a device including a culture tank having a culturing space surrounded by sidewalls, and a flow channel-forming member that penetrates through the sidewalls that face each other and is suspended in the culturing space along a predetermined direction; culturing cells in the culturing space and thereby forming a three-dimensional artificial tissue through which the flow channel-forming member penetrates; and removing the flow channel-forming member from the three-dimensional artificial tissue and thereby forming a perfusion flow channel that penetrates through the three-dimensional artificial tissue.

Abstract: An exemplary tissue compression device for forming an anastomosis between first and second anatomical structures includes a first device portion and a second device portion configured to mate with the first device portion. The first and second device portions are configured to magnetically draw together to compress tissue positioned therebetween. The device further includes a circuit assembly including an electrical element and a battery configured to energize the electrical element. The electrical element may be in the form of an electromagnet or an illumination device, for example. In exemplary versions, the first device portion may include a first circuit assembly having a first electrical element and a first battery, and the second device portion may include a second circuit assembly having a second electrical element and a second battery.

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

Abstract: A kit for placing a bypass between two body vessels (R, L) of a patient comprises two catheters (10, 11), two guide wires (30, 31) moveable within one of the catheters (10, 11) each and a bypass element delivery system (52, 53, 8) for holding a bypass element (6, 7). The bypass element delivery system (52, 53, 8) is moveable along the first guide wire (30) and the bypass element delivery system (52, 53, 8) is capable of releasing and setting free the bypass element (6, 7). The kit further comprises an expansible element (40) being capable of connecting with the bypass element delivery system (52, 53, 8), of moving the bypass element delivery system (52, 53, 8) towards the opposite end of the first guide wire (30) and of setting the bypass element delivery system (52, 53, 8) free. The inventive kit enables an atraumatic placement of a bypass.

Abstract: The present disclosure provides modular magnetic anastomosis devices that can be implemented in digestive surgery or in any circumstance of anastomosis between adjacent organs or two hollow viscera. The device is minimally invasive and easily and quickly delivered using laparoscopic or endoscopic procedures.

Abstract: Devices are used to modify a metabolic pathway of a digestive system by creating a pathway within the intestinal tract through an anastomosis between a proximal location within the intestinal tract and a distal location within the intestinal tract. A magnetic anastomosis compression device includes a first arm, a second arm, a resilient member, and a pair of magnets. The magnetic anastomosis compression device further includes a degradable retaining element. The retaining element temporarily holds the first arm and second arm in a wide configuration in opposition to the bias exerted by the resilient member. Upon the degradation of the retaining element, the resilient member causes the first arm and second arm to transition to a narrow configuration. The magnetic anastomosis compression device is configured to magnetically couple with another magnetic anastomosis compression device positioned within a different location within the intestinal tract.

Abstract: Systems and methods for performing transcatheter coronary artery bypass grafting procedures are provided. The methods generally involve passing the graft from the aorta to the coronary artery through the pericardial space. The systems include poke-out wires, a coring device, and devices for forming anastomoses at the proximal and distal ends of a vascular graft.

Abstract: A stabilization tool supports a blood vessel for suturing during cardiovascular surgery. The support vessel may typically be part of an artificial graft used in replacing an aortic arch. The stabilization tool has a central shaft with a mounting element at a first end. A plurality of retractable arms have their distal ends affixed to a second end of the central shaft. The retractable arms are movable between a nested position flanking the central shaft and a range of extended positions wherein proximal ends of the retractable arms are spaced away from the central shaft. A closing ring is slidable over the retractable arms from a deployed position adjacent the second end of the central shaft to a retracted position spaced away from the second end to move the retractable arms.