Abstract: An extravascular anastomosis device for facilitating side-to-side arteriovenous fistula creation and maintenance of patency thereof is presented. The device comprises two device halves each containing an anastomosis window which is in fluid connection with an interior space of the device. Further, the device comprises a pair of vessel capture spaces in which portions of the vessels to be joined are captured. The invention also has an embodiment wherein a method of joining a vein and an artery in order to create a fistula is presented.

Abstract: An intravascular device for treating atherosclerotic occlusive disease can include an annular band defining a longitudinal axis between proximal and distal ends. The annular band can have a plurality of barbs on its outer periphery. One or more intravascular devices may be applied in positions along a plaque accumulation site as needed to stabilize the site and/or hold pieces of plaque out of the way of blood flow. The barbs may be pressed into the plaque and/or blood vessel walls.

Abstract: Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alternative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.

Abstract: A method and devices that endoscopically create an anastomosis between two sections of the digestive tract, thereby allowing at least some chyme to bypass a section of the digestive tract while, optionally, the remaining chyme passes through the entire tract.

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: An endoprosthesis has an expanded state and a contracted state, the endoprosthesis includes a stent having an inner surface defining a lumen, having an outer surface, and defining a plurality of apertures through the outer surface, wherein the apertures are arranged in a micropattern; and a coating (e.g., polymeric coating) attached to the outer surface of the stent. The coating includes a base and a tissue engagement portion including a second surface facing outwardly from the stent, the tissue engagement portion including a structure that defines a plurality of holes extending inwardly from the second surface toward the base. The holes are arranged in a micropattern. When the endoprosthesis is expanded to the expanded state in a lumen defined by a vessel wall, the structure applies a force that may reduce stent migration by creating an interlock between the vessel wall and the endoprosthesis.

Abstract: A shunt rivet for implantation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease. The shunt rivet may be formed to have a central section, a proximal clinch section, and a distal clinch section each having one or more clinch members. These one or more clinch members may be trained to be resiliently biased to bend radially outwardly from the central section.

Abstract: The applicator related to the present invention is provided with a flexible sheath longer than the overall length of an instrument channel of a flexible endoscope; an operation part used outside the instrument channel; a deployed section that can be made to protrude from the front end of the sheath by operating the operation part and to pierce a tissue; a tissue fastening tool made of a superelastic wire formed in coil shape and housed inside the deployed section in a substantially extended condition; and a pusher that pushes out the tissue fastening tool from the deployed section when the operation part is operated.

Abstract: Techniques associated with a vascular anastomosis device are described, including a lower flange having a lower gripping surface and an interior surface, a diversion conduit attached to the lower flange, the diversion conduit having a lumen extending between an inlet and an outlet, the inlet forming an opening in the interior surface, an upper flange having an upper gripping surface, and being configured to move from a first position to a second position with respect to the lower flange, the first position being characterized by the upper flange being separated from the lower flange, the second position being characterized by the upper gripping surface being in contact with the lower gripping surface, and a biasing structure configured to exert a force on the upper flange in a direction from the first position toward the second position.

Abstract: A device for connecting two tubular vessels together in a side-by-side or tangential manner is disclosed. The device has an annulus and at least one series of fingers connected to and extending away from the annulus. In the preferred embodiment there are two sets of fingers connected to and extending away from the annulus in opposite directions. Each finger is preferably biased into an arcuate shape. In use, a deployment apparatus is used to constrain the fingers of the device to be in a relatively planar configuration. The deployment apparatus containing the device is placed between and in contact with the two tubular vessels so that one tubular vessel is above the device and one tubular vessel is below the device and so that the fingers of the device come into contact with the tissue of the vessels. As the fingers penetrate the vessels the constraint on the fingers is removed so that the fingers can assume their biased arcuate shape.

Abstract: An implantable tissue connector comprises a conduit and at least one bulge extending outwardly from the conduit's outer surface in a circumferential direction. At least one blocking ring loosely fitting over the outer surface with a clearance between the outer surface and the blocking ring is provided for mounting tubular living tissue within the clearance. The blocking ring has an inner diameter which is sized relative to an outer diameter of the bulge to prevent the blocking ring from slipping over the bulge when living tissue is mounted within the clearance. During implantation, the conduit is inserted into the tubular part of living tissue and over the bulge. Then, the blocking ring is pushed over the free end of the living tissue against the bulge. The living tissue is secured to the conduit with a self-enhancing effect when the tissue tends to be pulled off of the conduit.

Abstract: A shunt rivet for implementation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease.

Abstract: A system and method for endoscopically forming an anastomosis between two naturally adjacent points in the digestive tract. The system and method 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 suprapyloric anchor assembly includes an antral cap having at least three stabilizing members configured to reside in an antrum and engage tissue circumscribing a pyloric valve. A duodenal member is configured to reside at least partially in a duodenal bulb, and one or more tethers connect the antral cap to the duodenal member. The tether(s) is/are configured to allow passage of stomach contents through the pyloric valve. Optionally, one or more gastric balloon(s) may attached to the suprapyloric anchor and be inflated with the gastric cavity.

Abstract: According to an aspect of the present disclosure, an apparatus for forming an anastomosis between adjacent intestinal sections of tissue is provided. The apparatus includes an anastomosis device having an anvil and a tubular body portion, wherein the anvil is selectively attachable to the tubular body portion by a shaft; and a support structure for deposition between the intestinal sections of tissue. The support structure includes a body defining an aperture therein for receiving the shaft. The body has an outer terminal edge. The support structure includes at least one layer of expandable material disposed at the outer terminal edge of the body.

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: Devices, systems and/or methods for repairing soft tissue, such as, a lacerated tendon. A repair device includes a frame having a tubular structure with a longitudinal length and struts at least partially defining the tubular structure. The frame includes a first portion and a second portion with an intermediate portion therebetween, each extending along the longitudinal length. The intermediate portion is configured to substantially maintain a fixed position and is configured to be positioned over first and second ends of the lacerated tendon to substantially maintain the first end abutted against the second end. The first portion and the second portion of the frame are configured to be positioned over separate portions of the tendon and configured to move and elongate along a length of the respective first portion and second portion of the frame as the portions of the tendon elongate.

Abstract: Medical devices for closing a hole or holes in a subject's body, such as those related to transapical procedures, are disclosed. The medical devices can include a force-providing portion and a tissue-attachment portion. The medical devices can be configured for multiple positions including at least a constrained position and an unconstrained position. In some embodiments, the medical device may be used on a delivery device or delivery tool. In some embodiments, the force-providing portion can pivot radially outward and the tissue-attachment portion can become more constrained, and the hole can be at least partially closed. In some embodiments, the tissue-attachment portion can include a plurality of pins that assume a hook shape.

Abstract: A self-closing tissue fastener for use in wound closure and surgery has, in an annular configuration, a central ring; tissue-piercing spines projecting from a first side of the ring; and stabilizing members projecting from a second side of the ring. The fastener can be carried on the inside of a tube, where it is stable without additional restraint, as well as on the outside of a tube or mandrel. The device can be compressed from a planar state, as fabricated, to the annular state by compressing the stabilizers (or, if they are on the outside in the planar form, the barbs). Unlike present devices, which are not as stable in the annular state, the inventive device and an applicator therefore provide an open channel to a site of surgery, for passage of endoscopes or various endoscopic and similar instruments. In particular, the fastener can be delivered under endoscopic monitoring.

Abstract: An incision closure device includes an elongated handle portion including a distal end, a first connector detachably affixed to the distal end of the handle portion, and a second connector adapted to be axially moveable along the handle portion, wherein the first and second connectors are magnetically attracted to one another.

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: The present disclosure relates to a tissue repair device. The device includes a handle, a knob coupled to the handle, and a needle coupled to the handle. The needle includes a proximal end and a distal end, the distal end including a slot, wherein a first anchor is housed within the distal end and a second anchor is housed within the slot and located proximal to the first anchor. An actuator disposed within the needle and operatively coupled to the knob, wherein advancement of the knob allows for engagement of the actuator with the first anchor and subsequent advancement of the first anchor via the actuator. A method of tissue repair is also disclosed.

Abstract: An implantable flow connector for fluidically coupling a source tissue-enclosed body space with a destination element, comprising: a conduit having a lumen terminating at an orifice at a first end of the conduit implantable in the source body space through an opening formed in a tissue wall of the source body space, and a second end of the conduit implantable in the destination element through an opening in a surface of the destination element; and a circumferential flange, radially extending from the conduit proximate the conduit first end, configured to be implanted in the source body space adjacent an opening in the tissue wall of the source body space such that the conduit extends through the opening, the flange comprising one or more circumferentially adjacent sections at least one of which has a rigidity that decreases in a radially-increasing direction.

Abstract: The present invention is a new technology that addresses some of the deficiencies of current fracture fixation technology used in surgical procedures. It involves the use of a polymeric cored braided suture held in place by anchors implanted on each side of a fracture. The anchors must be secured into the bone while yet maintaining very high tensions in the suture during the deployment process. The polymeric cored braided suture is tensioned so as to compress the fracture and hold it in place, functioning as though it has sewn the bone fragment back together. This provides the rigid fixation of the fracture that is essential for primary healing to occur. Simultaneously, the tension preload provides compression which maintains fixation in the face of tensile and shear loads applied to the bone as a result of movement and weight bearing.

Abstract: An exemplary surgical staple may include a base including a first end and a second end; a single tine extending from the second end of the base; and a barb extending from the base at a location between the first end of the base and the second end of the base. An end of such a staple may be frangibly affixed to a feeder belt. Another exemplary surgical apparatus may include at least one staple including a base including a first end and a second end, a first tine extending from the second end of the base, and a second tine extending from the base at a location between the first end of the base and the second end of the base.

Abstract: Connector including a primary female connector having a form of a tapered cone having an opening at its deepest point, and a spring loaded insert configured to be inserted through said opening essentially along a central axis of said primary female connector.

Abstract: A tissue clip for adjoining tissues including a body portion, a biasing mechanism interconnecting the body portion to a tissue grasping mechanism, the grasping mechanism having a first condition wherein the grasping mechanism is extending against and away from the body portion and a second condition wherein the grasping mechanism is biased against the body portion. A tissue clip and deployer combination. A method of interconnecting tissue by deploying the tissue clip, puncturing tissue to be interconnected with the tissue clip, and interconnecting the tissue. A method of treating an aneurism by deploying the tissue clip at an aneurism site, closing off the aneurism site with the tissue clip, and treating the aneurism. A method of imaging a surgical procedure with ultrasound by modifying a surface of a metal surgical instrument, and imaging the metal surgical instrument with ultrasound during a surgical procedure.

Abstract: Surgical coils are disclosed for marking, anchoring, stapling and suturing. Such surgical coils may be implanted in the body by deforming them to a small cross section profile, sliding them through a low profile delivery device then deploying them from an embodiment of a delivery device at a targeted site. Embodiments of surgical coils when deployed revert back to a coiled configuration and circle tissue at the target site. Such surgical coils may be deployed about attachment members, such as suture lines, marker lines and the like for anchoring same.

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: 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 connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, the connector can include a connector body having an outer surface defining a first outer perimeter and an inner surface defining a lumen. The connector can also include a connecting device having an open configuration and a plurality of closed configurations. The connecting device can include first and second members configured to engage each other to secure the fluid conduit to the connector. The connecting device can also include a plurality of closed configurations for securing fluid conduits of different sizes.

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 medical device includes an outer shell defining a cavity, wherein the shell is movable between a deformed and unstressed state, a magnet disposed within the cavity, and a filler material carried within the cavity conforming to the interior shape of the shell in the unstressed state and being capable of holding its shape in the deformed state. The filler material converts from the deformed state to the unstressed state at a temperature not greater than human body temperature.

Abstract: An attachment mechanism for coupling a stent to a delivery system is disclosed. The delivery system includes an inner shaft assembly. The attachment mechanism is configured to pivot relative to the inner shaft assembly of the delivery system in order to release the stent from the delivery system upon retraction of a delivery sheath capsule compressively containing the stent.

Abstract: The disclosure relates to support frames for prosthetic implantable valves. The support frames may include a plurality of symmetrically arrayed interconnected U-shaped member structures. Preferred support frames are tubular structures enclosing a longitudinal axis and including a plurality of U-shaped member structures facing a distal or a proximal end of the support frame. Each U-shaped member structure may be connected to a single longitudinally adjacent U-shaped member facing in an opposite longitudinal direction, as well as two laterally adjacent U-shaped members.

Abstract: A device for producing anastomoses between first and second hollow organs, each having inner and outer surfaces. The device comprises a sleeve with an electrode arrangement, over which the first hollow organ is placed such that its inner surface comes to lie on a outermost surface of the sleeve, and an outer electrode arrangement, which can be brought into electrical contact with the opposing electrode arrangement carrying the second hollow organ, which is pushed over the first hollow organ. The outer electrode arrangement comprises a plurality of lamellae, configured and arranged such that, in a closed state, the lamellae form a through aperture and the inner edges of the lamellae lie against the second hollow organ and, in an open state, a gap is formed between the lamellae through which the hollow organs connected to one another can be guided outwardly out of the through aperture.

Abstract: An intraluminal device may be used at a bifurcation to anchor in an afferent vessel, allow perfusion to efferent vessels, and act as scaffolding to inhibit herniation of objects out of a neck of a bifurcation aneurysm. An intraluminal device may include a first side; a second side opposite the first side across a longitudinal axis of the intraluminal device; a proximal section configured to anchor in an afferent vessel; a distal section comprising a first wing and a second wing wherein, in an expanded state, the first wing extends from the first side to the second side and the second wing extends from the second side, through an opening of the first wing, and to the first side.

Abstract: A system and a method for joining an upper and lower esophageal sacs in an infant are provided. The system includes a first elongate member having a first magnet, the first magnet including an end portion configured to abut an interior surface of the upper esophageal sac. The system also includes a second elongate member having a second magnet, the second magnet including an end portion configured to abut an interior surface of the lower esophageal sac. The system further includes a third elongate member having a third magnet and a spacer positioned distal to the third magnet. The third elongate member is positionable in the upper esophageal sac after the first elongate member has been removed. A magnetic force between the first magnet and the second magnet is configured to pull the first magnet and the second magnet towards each other to lengthen the upper and lower esophageal sacs.

Abstract: An apparatus enables concurrent restoration of a gastroesophageal valve and tightening of the lower esophageal sphincter. The apparatus comprises a longitudinal member having a distal end arranged to be received within a stomach, a tissue shaper at the distal end of the longitudinal member that forms a gastroesophageal valve from stomach tissue, and a tissue gatherer that gathers fundus tissue at or aboral to the gastroesophageal junction to reduce an esophageal opening into the stomach and tighten the lower esophageal sphincter. A fastener deployer then deploys at least one fastener pair to maintain both the restored gastroesophageal valve and the tightened lower esophageal sphincter.

Abstract: A mounting tool (20) and method for mounting an anastomotic device (10, 200) to an end (220, 221) of a tubular structure (90) comprises a receiving portion for receiving a rigid part (11, 13) of said device (10, 200) and a conical portion with a large end facing said rigid part (11, 13) having a diameter larger than or equal to the rigid part (11, 13) and a small end. The conical portion comprises a releasable portion and is insertable into the elastic part (12) arranged inside the tubular structure (90) for expanding the diameter thereof and for passing the elastic part (12) beyond the large end and onto a rigid part (11, 13) arrangeable at the receiving portion.

Abstract: A surgical instrument including a tool member cover and a cover deployment device are disclosed. The cover is supported adjacent to or on the tool assembly of the surgical instrument and is movable from a first position in which the tool assembly is uncovered to a second position in which the tool assembly is at least partially encompassed by the cover. The deployment device is provided for moving the cover from the first position to the second position.

Abstract: The invention relates to a vessel connector (10) for surgically connecting two vessels and/or prosthetics to each other, comprising a sleeve-shaped body (1), the walls of which are designed to be elastic, such that the force acting on the ligature or suture is limited to the extent that no pressure points or necroses occur in the vessel. It is made of two substantially rigid outer rings (2), delimiting the sleeve-shaped body, and webs (3) present between the rings, wherein at least regions of individual webs have a shape (4) deviating from a straight line over longer distances, and it has at least one ring-shaped region (5) of higher elasticity between the rigid rings. The connector provides a blood-tight connection of at least two natural or artificial vessels, including prosthetic connections, a prosthesis to a natural vessel, or two prostheses to each other.

Abstract: A prosthesis system for repair of a transected body vessel is provided. The system can include first and second prostheses each including a tubular graft body and a support structure. Each prosthesis can be expandable between a compressed and an expanded configuration. In the expanded configuration, outer surfaces of the first and second prostheses can engage walls of the body vessel. The system can include a sleeve member formable into a tubular body. The first and second prostheses can be coupled to one another at a joint to form a coupled prosthesis. The sleeve member can receive the coupled prosthesis and cover the joint to inhibit leakage therefrom. The prosthesis system can connect first and second portions of the body vessel to permit blood flow therethrough. The sleeve member can be discrete to the coupled prosthesis or can have one end fixedly attached to the coupled prosthesis.

Abstract: A bariatric device for use in inducing weight loss, comprising a cardiac element, a pyloric element, and a connecting element between the two other elements, wherein the connecting element provides structure between the cardiac and pyloric elements, keeping them largely in place and at least intermittently touching and applying pressure to the stomach's cardiac, adjacent fundic and pyloric regions, respectively, which produces a satiety signal to the user, giving the recipient a feeling of fullness and reducing his or her hunger feelings. Alternatively, the cardiac and pyloric elements may be symmetrical, so that the device can orient itself either way in the stomach and still achieve the weight loss function.

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: In some aspects, a surgical procedure for the removal of a prostate gland is provided. The procedure comprises: (a) positioning an implant material within the urethra, (b) removing the prostate, thereby creating a urethral stump and a bladder neck, wherein the implant material occupies the urethral stump, the bladder neck, or both, and (c) securing the bladder neck to the urethral stump in an anastomosis procedure to establish a path of urine flow from the bladder to an external urethral opening (e.g., the meatus). Subsequently, the implant material is removed from the urethra, for example, by natural urine voiding or by flowing a removal fluid through and/or around the implant material in the urethra. In other aspects, a medical kit is provided.

Abstract: Medical devices having a platform and an arm movable between a collapsed position and an expanded position. In some embodiments, the platform comprises at least one of a magnetically-attractive material and a material capable of being magnetically-charged. Methods of use.

Abstract: An embodiment of the invention relates to an apparatus for supporting first and second blood vessels connected by an anastomosis at a fistula, the apparatus comprising: a coupler that seats on and couples to the first blood vessel; and a sleeve connected to the coupler that ensheathes a portion of the second blood vessel in the vicinity of the fistula.

Abstract: Tissue management methods can include inserting a clamping device into a vessel and clamping a vessel wall via the clamping device. Tissue can be dilated about the clamping device and an anastomotic device provided to the vessel.

Abstract: A method of performing a bariatric procedure through a natural body orifice is disclosed. The method comprises the step of providing a surgical instrument, comprising a handle portion, an elongated portion extending distally from the handle portion, and an end effector disposed adjacent a distal end of the elongated portion. The method also comprises the steps of inserting the surgical instrument through a natural body orifice of a patient such that the end effector is adjacent a portion of the patient's stomach, and using the surgical instrument to perform a surgical task.