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 endoscopic or laparoscopic conduit delivery device (1) comprises first and second separately manipulable introducers (3, 5) with a laparoscopic conduit (80) having first and second ends (83, 84) and an intermediate portion being mounted onto the introducers in a substantially U shape. The first end and a first portion of the laparoscopic conduit is retained onto the first introducer and the second end and a second portion of the laparoscopic conduit is retained on the second introducer and the intermediate portion extends between the first and second introducers. A main sheath (42) is over the first and second introducers. The endoscopic or laparoscopic conduit delivery device is introduced to a body cavity through an endoscopic or laparoscopic port (50).

Abstract: A gastroplasty method involves a staple line that terminates prior to reaching the gastroesophageal junction such that the bypassed portion of the stomach does not require resection. Additionally, bougies are taught that assist a physician in following the improved staple line of the present invention.

Abstract: A connector for joining first and second hollow structures, comprising a fluid-constraining tube having a fluid-constraining neck extending therefrom, wherein the tube and the neck each comprise a lumen having first and second openings, the neck being joined to the tube such that fluid entering the first opening of the tube can exit the second opening of the tube, and fluid entering the first opening of the neck can exit the second opening of the tube; at least the portions of the tube adjacent to the first and second openings of the tube being biased radially outwardly so that they normally assume a radially-expanded configuration, but being capable of being restrained in a radially-contracted configuration, wherein the tube is sized so that, when it is in its radially-expanded configuration, it has an outer diameter which is larger than the inner diameter of the second hollow structure.

Abstract: An apparatus for joining organ wall portions of first and second hollow organs, including first and second connectors, wherein the first and second connectors are magnetically attracted to one another. A device for delivering and deploying the first and second connectors to portions of the first and second hollow organs can be provided, wherein the device is configured and dimensioned to axially align the first and second connectors for performing circular anastomosis of the first and second hollow organs.

Abstract: The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point and moving the first tissue contact point from a position initially distal to, or in line with, a second tissue contact point to a position proximal of the second contact point, thereby forming the tissue fold, and extending an anchor assembly through the tissue fold from a vicinity of the second tissue contact point. Adjustable anchor assemblies; as well as anchor delivery systems, shape-lockable guides and methods for endoluminally performing medical procedures, such as gastric reduction, treatment of gastroesophageal reflux disease, resection of lesions, and treatment of bleeding sites; are also provided.

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.

Abstract: Endoscopic devices and methods used for fastening multiple tissue layers, such as, for example, an endoscopic fundoplication procedure, are disclosed. The device may include, for example, an elongated tubular member having a proximal end for extending outside of the body and a distal end for positioning proximate the multiple tissue layers, a grasper configured for positioning proximate the distal end of the tubular member and for grasping at least one of the multiple tissue layers, a device coupled to the distal end of the tubular member for folding the multiple tissue layers together, a tissue fastener configured to be inserted into the tissue layers to hold the tissue layers together, and a fastener head for inserting the tissue fastener into the tissue layers.

Abstract: A magnetic anastomosis device is provided for forming an anastomosis between two bodily walls. The device includes a first magnet assembly and a second magnet assembly configured to be magnetically coupled to compress the two bodily walls therebetween to form the anastomosis. The first magnet assembly includes a first magnet and a second magnet disposed within a first jacket and the second magnet assembly includes a third magnet and a fourth magnet disposed within a second jacket.

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: An instrument for fastening tissue within a body includes an elongated tube having a proximal end for extending outside of the body and a distal end for positioning proximate the tissue; and a distal member configured to fold the tissue together. The distal member includes a first member having a proximal end coupled to the distal end of the tube; and a second member pivotably coupled to the distal end of the first member. The first and second members are configured to install at least one fastener. A grasper is coupled to at least one of the first member and the second member. The second member is pivotable between an open position for receiving tissue and a closed position for folding tissue therebetween. The grasper is configured to project outward from at least one of the first member and the second member when in the open position.

Abstract: The present embodiments provide medical apparatuses, systems, and methods for rapidly forming an anastomosis between two viscera. The medical apparatus generally comprises two bases with two clamp members rotatably attached to the bases, the clamp members being capable of compressing tissue. The system generally comprises positioning and then deploying the medical apparatus between and within two stomas via an elongate member. The method generally comprises using the medical system to create an anastomosis between the stomach and the jejunum.

Abstract: Provided is a medical treatment endoscope including: an endoscope main body which includes an elongated insertion portion having a lumen and an image capturing mechanism disposed in a distal end of the insertion portion; an arm which is able to be inserted into or extracted from the lumen and has a treatment tool lumen for allowing an endoscope treatment tool to be inserted therethrough; and a positioning mechanism which positions a part of the arm inserted through the lumen with respect to the endoscope main body.

Abstract: A drive system for controlling movement of an elongate member includes a base unit having a first rotatable knob and a second rotatable knob, a follower assembly including a follower slidably coupled to a guide rail, a longitudinal movement wire, and a rotational movement wire. The follower includes a longitudinal movement pulley, a rotational movement pulley, and an alignment element structured to receive an elongate member such that the elongate member is attachable thereto. The longitudinal movement wire operably couples the first rotatable knob to the longitudinal movement pulley such that rotation of the first knob drives the follower in a longitudinal direction along the guide rail. The rotational movement wire operably couples the second rotatable knob to the rotational movement pulley such that rotation of the second knob rotates the alignment element and attached elongate member.

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

Abstract: The present invention provides docking heads to be mounted on a graft so as to establish a vascular device that is coupled to a blood vessel with aneurysm, and dedicated delivery devices as well as methods of coupling. The vascular device comprises a graft having docking head at the proximal portion and another docking head at its distal portion, or two docking heads if the graft is bifurcated. The docking heads comprises a hollow truncated cone having a passage adapted to correspond the outer diameter of the graft and is provided with a plurality of outwardly pointing and inclined barbs. The vascular device is coupled to the blood vessel on both sides of the aneurysm while the docking heads act as guiding, anchoring and sealing means in a suture-less and rapid manner. The vascular device is modular and can be prepared according to the condition of the aneurysm and the dimensions of the blood vessels during operation.

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 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 present disclosure is directed to devices for approximating body vessels and method for performing the same. In accordance with one aspect of the present disclosure, the device includes an inner member having a first expandable anchor operatively coupled near a distal end thereof, an outer member having a second expandable anchor, and a sleeve disposed about at least a portion of the inner member and the outer member.

Abstract: In accordance with the present invention there is provided apparatuses and methods for using a medical instrument including a sizing and positioning adapter. The apparatus comprises an adapter for a medical instrument, the adapt having a body having a shim portion and an instrument holding portion adjacent the shim portion, wherein the shim portion provides an enlarged peripheral surface adjacent the medical instrument such that when the medical instrument is held in the instrument holding portion and the medical instrument and body are inserted through an opening in a patient tissue, at least a portion of the enlarged peripheral surface is in contact with at least a portion of the periphery of the opening in the patient tissue.

Abstract: A surgical suture needle assembly includes an elongate tube defining a lumen through at least a portion of a length thereof; and a wound treatment material contained within the lumen of the suture structure. Methods of using the surgical suture needle assembly in anastomotic procedures and the like are disclosed.

Abstract: Devices, systems and methods are disclosed for the formation of an arteriovenous fistula in the limb of the patient. Embodiments include a device for the creation, modification and maintenance of a fistula that includes an integral fistula creation assembly near its distal end that passes through the skin of the patient, through a first vessel such as an artery, and into a second vessel such as a vein. The fistula creation assembly preferably includes an anastomotic implant that is placed within the fistula to maintain long-term blood flow therethrough. The devices, systems and methods can be used to treat patients with one or more numerous ailments including chronic obstructive pulmonary disease, congestive heart failure, hypertension, hypotension, respiratory failure, pulmonary arterial hypertension, lung fibrosis and adult respiratory distress syndrome.

Abstract: The present disclosure is directed to devices for approximating body vessels and method for performing the same. In accordance with one aspect of the present disclosure, the device includes an inner member, an outer member having a lumen dimensioned to receive the inner member, an expandable anchor for engaging the a first body vessel, and a joining member for engagement between the first body vessel and the second body vessel.

Abstract: A sleeve type fixing method for anastomosis for tubular organs, using an anastomosis device which has an inner and an outer ring. The outer ring is made of elastic material, and the inside of the lower portion of the outer ring has an inwardly protruding ring. The protruding ring is clamped to the connecting portion of the inner ring. In operation, one intestine is sleeved and fixed on the flange of the anastomosis portion of the inner ring, and the outer ring is overturned to let the lower edge overturn. Then another intestine is sleeved and fixed on the outer ring, and both the outer ring and the intestine are overturned so that the intestine is connected in the inner edge of the outer ring. Finally the inner ring is inserted and the two intestines overlapped on the anastomosis portion of the inner and outer ring.

Abstract: A vascular graft with trim lines is described, the trim lines providing a guide for precision shaping of the cuff. The trim lines may be printed or otherwise disposed on a surface of the cuff or included on a template designed for disposition over the cuff. The trim lines may also be disposed on a side of a pocket into which the cuff is positioned for trimming. Also described is an apparatus and method for precise trimming of a vascular graft.

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

Abstract: A medical anastomosis apparatus is provided. The medical anastomosis apparatus includes a cylindrical body which has a hollow portion and extends in a longitudinal direction, a pressing rod which is provided inside of the hollow portion of the body to translate along the hollow portion, a knob which is coupled to the pressing rod to provide a driving force to translate the pressing rod, a guide member which is inserted into one end of the body and simultaneously coupled to expose a portion of the body and has a pressing unit formed therein to move radially upon translation of the pressing rod, and a staple cartridge which is inserted around an outer circumferential surface of the guide member and then coupled to the body and has built-in staple clips that protrude outward upon movement of the pressing unit.

Abstract: The invention provides a device, assembly, and method for transoral endoscopic restoration of a gastroesophageal flap valve. The invention also provides a self-steering and self-closing tissue fixation device for tissue fixation, and an invaginator device for gripping and maneuvering tissue. The restoration device includes a longitudinal member arranged for transoral placement into a stomach, a tissue shaper carried on the longitudinal member that causes stomach tissue to assume a shape related to a gastroesophageal flap, and a tissue fixation device that maintains the shaped stomach tissue in a shape approximating a gastroesophageal flap. The tissue shaper may include a mold. The device may include the invaginator device for gripping and maneuvering esophageal tissue to aid restoration of the gastroesophageal flap, and may include the tissue fixation device.

Abstract: An end effector for use with a surgical instrument having a first cartridge assembly configured to deploy a first set of fasteners and a second cartridge assembly disposed distally of the first cartridge assembly. The second cartridge assembly is configured to move between an open position and an approximated position relative to clamp tissue. A central rod extends between the first cartridge assembly and the second cartridge assembly.

Abstract: An assembly having a stabiliser and an instrument to be positioned in or around a passage surrounded by body tissue, in particular vascular tissue. The stabiliser is provided with one or more suction mouths running in the shape of a loop, which suction mouths can be operationally connected to suction means in order to suck tightly to tissue close to and around said passage, which may still have to be made. The instrument has a head section for performing operations on vascular tissue. The stabiliser and the instrument are provided with, respectively, an instrument stop provided on the stabiliser and a stabiliser stop provided on the instrument, which, in the stop position when they are in contact with one another, unambiguously define the position of the head section with respect to the position of the loop shape. The instrument can be an applicator for positioning and fixing a fixing device in or around the passage, the head section being equipped for carrying and releasing the fixing device.

Abstract: Apparatus and methods for endoscopic colectomy are described herein. A colectomy device having a first and a second tissue approximation device is mounted on a colonoscope separated from one another. During deployment of the colectomy device, a diseased portion of the colon is positioned inbetween the tissue approximation devices. The tissue approximation devices are radially expanded such that they contact and grasp the colon wall at two sites adjacent to the diseased portion of the colon. The diseased portion is separated from the omentum and is transected using a laparoscope or is drawn into the colonoscope for later removal. The tissue approximation devices are then urged towards one another over the colonoscope to approximate the two free edges of the colon into contact together where they are fastened to one another using the tissue approximation device as a surgical stapler to create an end-to-end anastomosis.

Abstract: A stent for supporting part of a blood vessel includes a supporting portion around which or within which a part of an intact blood vessel other than a graft can be placed. The stent internally or externally supports that part of the blood vessel. The supporting portion of the stent is of a shape and/or orientation whereby flow within the vessel is caused to follow a non-planar curve. By maintaining a non-planar curvature in the vessel itself, favorable blood flow velocity patterns can be achieved through the generation therein of “swirl” flow. Failures in such vessels through diseases, such as thrombosis, atherosclerosis, intimal hyperplasia or through blockage, kinking or collaps, can be significantly reduced.

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: A method for implementing vascular anastomosis in the attachment of a graft vessel to a target vessel such as a coronary artery, and subsequently creating a passageway between the vessels in order to establish fluid flow communication therebetween. Further is to the provision of novel devices which are utilized in implementing the steps of attaching a graft vessel to a target vessel such as a coronary artery through vascular anastomosis, and thereafter creating a fluid flow passageway therebetween.

Abstract: A medical tool comprising an electromechanical driver and a surgical instrument attachment for use in invasive surgery, including a handle coupled to a flexible sheath which is in turn coupled to a surgical attachment. The handle of the driver includes the electromechanical driver and at least one processor element which controls the actions of the electromechanical driver, and therefore the application elements of the surgical attachment, based on information relayed between the processor element and remotely activatable sensor assemblies in the surgical instrument attachment.

Abstract: The present invention includes a method and apparatus for adhering tissue to one another. In an embodiment of the present invention the two tissues to be joined, for example the lower esophagus and the fundus of the stomach, are first placed adjacent to one another. Next a first restraint is placed near the outside surface of one of the tissues and a second restraint is placed near the outside surface of the other tissue. An irritant is then placed between the two adjacent tissues. The restraints, and consequently the tissue surfaces, are then drawn together. As the touching irritated tissue surfaces heal they will become bonded to one another and their need for the mechanical fastening of the restraints, to secure them together, will be diminished.

Abstract: A scaffold is provided for managing access through tissue. The scaffold can support the tissue during medical procedures. The scaffold is placed around or proximate an opening in tissue. The scaffold can expand when medical devices are introduced through the scaffold and through the opening and retract when the medical devices are removed. When the medical devices are removed, the scaffold closes automatically to substantially close the opening.

Abstract: An apparatus for joining organ wall portions of first and second hollow organs, including first and second connectors, wherein the first and second connectors are magnetically attracted to one another. A device for delivering and deploying the first and second connectors to portions of the first and second hollow organs can be provided, wherein the device is configured and dimensioned to axially align the first and second connectors for performing circular anastomosis of the first and second hollow organs.

Abstract: A treatment method on tissues in a body cavity includes: a first step of forming a hole for communicating first body tissue with second body tissue while both are in close contact with each other; and a second step of endoscopically inserting a treatment device into the second body tissue through the hole.

Abstract: A device is disclosed that provides for the protection of intestinal anastomosis sites and other body sites from bodily fluids and contaminants. Additionally, the device provides the ability to create negative pressure at the site of the obstruction to ensure that contaminants flow from the visceral compartment into the inner lumen of the bowel. Further, the device provides the sectional forces through natural constrictions of the intestinal muscles through peristaltic action.

Abstract: A tool to fasten tissue or to fasten a prosthetic to tissue includes a gripper to hold one or more tissue portions, a needle, an actuator to drive the needle, a fastener cartridge to store one or more tissue fasteners, a holder cartridge to store one or more holders, and a holder applier to secure one of the holders on one of the fasteners. The actuator drives the needle and the needle pulls a first fastener from the fastener cartridge. The actuator drives the needle through the one or more tissue portions held by the gripper to form a hole in the tissue portions. The needle pulls a leading portion of the first fastener through the hole without a trailing portion of the first fastener being pulled through the hole. The holder applier secures a first holder from the holder cartridge onto the leading portion of the first fastener.

Abstract: An anastomotic connector comprises a generally tubular main body having a distal end and a proximal end, and an anchor member integrally coupled to the distal end of the tubular main body. The anchor member includes first and second annular flanges that are movable from a first loaded position to a second expanded position. In the second expanded position, the annular flanges are substantially perpendicular to a longitudinal axis of the tubular main body portion.

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: The invention relates to an apparatus and method for forming a hole in a wall of a hollow organ. The applicator includes a hole forming element for forming a hole in the wall of the organ, a positioning means for positioning the hole forming element, and a retractor element. In addition, the applicator includes a sequencing means for coordinating the relative movement of the retractor element and the hole forming element in a sequential manner to thereby carry out a procedure for forming a hole in the wall of the hollow organ. The sequencing means may further include a safety latch element operatively coupled to the retracting means and the hole forming element. The safety latch of the invention keeps prevents damage to the internal surface of the organ during the formation of the hole.

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: Apparatus is provided for applying one or more patches to a tubular structure in a body of a patient. The apparatus includes an applicator, which is configured to removably hold the one or more patches, and to place the one or more patches at least partially around the tubular structure. The applicator includes one or more patch supports. Each of the patch supports includes a yielding pad, which is removably coupleable to one of the patches; and a stiff back support structure, to which the yielding pad is fixed. Each of the patch supports is shaped so as to define at least one chamber that itself has a volume of at least 0.5 ml when the patch supports are in respective resting states. Other embodiments are also described.

Abstract: Methods and devices for treating obesity are provided, and more particularly, methods and devices for performing gastric bypasses are disclosed. In one exemplary embodiment a gastric bypass procedure is provided that includes forming a gastro-entero anastomosis between a stomach and an intestine and forming an entero-entero anastomosis between a portion of the intestine distal to the gastro-entero anastomosis and a portion of the intestine proximal to the gastro-entero anastomosis. A surrogate path is formed between the esophagus and the gastro-entero anastomosis to at least partially direct fluid from the esophagus to the intestine by way of the gastro-entero anastomosis, thereby bypassing the stomach. Still further, methods for repairing an abdominal aortic aneurysm and leaking heart valve are also disclosed.

Abstract: A method of performing a surgical anastomosis is disclosed. The method includes providing an anastomotic device including a fluid supply channel extending between a handle assembly and a head assembly. The method also includes positioning the head assembly of the anastomotic device adjacent a hollow tissue organ, inserting the head assembly of the anastomotic device into the hollow tissue organ, and discharging an inflation fluid through at least one fluid outlet and into the hollow tissue organ to insufflate at least a portion of the hollow tissue organ.

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.