Abstract: A surgical apparatus for applying tissue fasteners is provided. The surgical apparatus includes a handle assembly, an elongated body that extends from the handle assembly, and a tool assembly mounted on the end of the elongate body. The tool assembly includes a cartridge assembly for receiving the tissue fasteners and a housing assembly for receiving a looped member. The tool assembly is configured to advance the tissue fasteners into the looped member to secure tissue between the fasteners and the looped member.

Abstract: Devices and methods are disclosed for the control of blood perfusion pressure within a blood vessel that undergoes arterialization. A cannula is introduced that contains a stenosis that either resorbs or is removed in time, allowing a gradual increase in blood pressure between two blood passages connected at either ends of the cannula. Particular emphasis has been made with the use of the cannula for the vessels in the heart.

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

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

Abstract: Pharmaceutically acceptable hydrogel polymers of natural, recombinant or synthetic origin, or hybrids thereof, are introduced in a dry, less hydrated, or substantially deswollen state and rehydrate in a physiological environment to undergo a volumetric expansion and to affect sealing, plugging, or augmentation of tissue, defects in tissue, or of organs. The hydrogel polymers may deliver therapeutic entities by controlled release at the site. Methods to form useful devices from such polymers, and to implant the devices are provided.

Abstract: Gastric space occupying devices are provided that include a stent configured for deployment in the gastrointestinal tract of a patient, and in particular, for deployment in the esophagus or the stomach. Secured to the stent is an expandable member that is adapted to reside within the patient's stomach. When expanded, the expandable member occupies a predefined volume within the patient's stomach and is further tethered to the deployed stent, thereby retaining or anchoring the expandable member within the stomach. Methods and systems for the deploying the space occupying devices are also provided.

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

Abstract: An auger is axially fixed to and positioned within a cutter. The auger and cutter advance at the same time relative to a contact structure placed against a vessel, penetrating the wall of the vessel and cutting a tissue plug. When the auger and the cutter are retracted from the vessel wall, the tissue plug is retained by the auger and cutter and removed from the vessel wall. The auger and the cutter thus create an opening in the vessel wall, without the need for a prior incision in that wall.

Abstract: A method and instruments used to performing an end-to-end anastomosis between two portions of intestinal tissue is disclosed. The method involves drawing a first portion of intestinal tissue over a portion of a bioabsorbable stent. The end of the first portion of intestinal tissue is everted on the stent to create a collar of exposed inner intestinal tissue. A second portion of intestinal tissue is drawn over the stent and over the exposed intestinal tissue. A bandage containing one adhesive compound selected from the group of an adhesive and an adhesive initiator is wrapped about the juncture. The other adhesive compound is applied to saturate the bandage and the combination of an adhesive and an adhesive initiator sets the adhesive to adhere the first portion and the second portion of adhesive to the bandage.

Abstract: This invention is directed to prosthesis, which, when implanted into a mammalian patient, serves as a functioning replacement for a body part, or tissue structure, and will undergo controlled biodegradation occurring concomitantly with bioremodeling by the patient's living cells. The prosthesis is treated so that it is rendered non-antigenic so as not to elicit a significant humoral immune response. The prosthesis of this invention, in its various embodiments, thus has dual properties. First, it functions as a substitute body part, and second, it functions as bioremodeling template for the ingrowth of host cells.

Abstract: An endoscopic device separates ingested food from gastric fluids or gastric fluids and digestive enzymes, to treat obesity. In a particular embodiment a gastric bypass stent comprises a tubular member and two or more stent members defining a lumen. The tubular member has a substantially liquid impervious coating or covering and one or more lateral openings to permit one-way liquid flow.

Abstract: The present disclosure relates a device for joining a first body vessel to a second body vessel, including an inner member having a distal end portion and defining a longitudinal axis, an outer member defining a lumen dimensioned to receive the inner member therein, and a radially expandable anchor disposed at the distal end of the inner member, the expandable anchor having an initial condition wherein the expandable anchor is disposed between the outer member and the inner member and an expanded condition wherein the expandable anchor is radially larger than the expandable anchor in the initial condition.

Abstract: A handle assembly facilitates the removal of a sterile inner tray containing sterile medical instruments from a medical kit during an OR procedure. The handle assembly may have a handle coupled with an elongated member having a male end and a female end. The inner tray may be wrapped in medical packaging. Subsequently, the elongated member may be wrapped around the inner tray and the male and female ends interconnected. The inner tray may be positioned inside of an outer tray. A bacterial barrier may be formed over a portion of the outer tray to enclose the inner tray. The inner tray, including the medical instruments, may then be sterilized by a sterilization process. During an OR procedure, the handle assemble allows a sterile nurse to remove the sterile inner tray from the non-sterile outer tray without making contact with the non-sterile outer tray and/or contaminating the sterile medical instruments.

Abstract: A method for performing end-to-end vessel anastomosis includes providing a vessel support including a vessel receiving portion and a handle portion extending therefrom. The vessel receiving portion is an annulus. The vessel receiving portion is positioned around the end of a first vessel and the end of the first vessel is everted about the outer diameter of the vessel receiving portion such that the inner surface of the vessel is directed outwardly. The end of the second vessel is positioned over the everted end of the first vessel such that the inner surface of the second vessel is disposed against the inner surface of the first vessel. The ends of the vessel are secured either with a suture or a surgical adhesive. The handle portion of the vessel support may be removed.

Abstract: Provided are an artificial dura mater having a laminated constitution of at least two layers of in vivo degradable polymers, at least one layer of them being a substrate layer, the substrate layer being formed of a lactic acid/glycolic acid/?-caprolactone copolymer, the copolymer having a component molar ratio of 60-85:3-15:10-30 mol % and the copolymer having an average chain length that satisfies the following expressions (1) to (3) and a process for the production thereof, and when this artificial dura mater is used, no liquid leakage is caused since the bloating of suture holes is small, and the period of time for which it retains its strength is suitably a little longer than the period of time required for the regeneration of an autodura mater, 2<L(LA)<[LA%/(LA%+GA%+CL%)]×X×0.058??(1) 1<L(GA)<[GA%/(LA%+GA%+CL%)]×X×0.58??(2) 1<L(CL)<[CL%/(LA%+GA%+CL%)]×X×0.

Abstract: Pharmaceutically acceptable hydrogel polymers of natural, recombinant or synthetic origin, or hybrids thereof, are introduced in a dry, less hydrated, or substantially deswollen state and rehydrate in a physiological environment to undergo a volumetric expansion and to affect sealing, plugging, or augmentation of tissue, defects in tissue, or of organs. The hydrogel polymers may deliver therapeutic entities by controlled release at the site. Methods to form useful devices from such polymers, and to implant the devices are provided.

Abstract: A sheath having a proximal portion attached proximal to an anastomotic site. The sheath includes at least one biodegradable portion and at least one non-biodegradable portion. The sheath prevents anastomotic leakage of tissue luminal contents into the surrounding cavity. A method for using the sheath is also disclosed.

Abstract: An areal implant has a long-term-stable, mesh-like basic structure which has pores of a size in the range from 1.5 mm to 8 mm and is provided, at least in a part area, on both sides with a synthetic, resorbable polymer film. The two polymer films are glued or welded together in pores of the basic structure.

Abstract: A coupler includes a saddle, a channel, a tissue clamp, and a flange. The channel has a first end of substantially elliptical cross-section connected to the saddle and a second end of substantially circular cross-section. The tissue clamp is positioned around the channel. The flange is formed adjacent to the second end of the channel. A conduit coupling device is formed by securing flanges of two couplers together with a clamping ring.

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

Abstract: A biocompatible fastener particularly well-suited for use in fundoplication procedures. In a preferred embodiment, the fastener is designed to break within the span of approximately three to six months after implantation and comprises a male portion and a female portion. The male portion includes a first base member, the first base member being generally flat and oval. A pair of male members are mounted on the bottom surface of the first base member, each male member comprising a cylindrical post extending downwardly from the bottom surface of the first base member and a conical head disposed at the bottom end of the post. The female portion includes a second base member, the second base member being generally flat and oval. A pair of sleeves are mounted on the top surface of the second base member and extend upwardly therefrom. Each sleeve defines a bore adapted to receive a head from a corresponding male member and has an inner flange formed thereon.

Abstract: The present invention is directed to absorbable/biodegradable composite yarns, each comprising at least two types of fibrous components having distinctly different absorption and strength retention profiles and the use of these composite yarns to construct surgical implants, such as sutures and meshes with integrated physicochemical and biological properties, modulated through varying the individual yarn content and controlling the geometry of these constructs.

Abstract: A method for performing end-to-end vessel anastomosis includes providing a vessel support including a vessel receiving portion and a handle portion extending therefrom. The vessel receiving portion is an annulus. The vessel receiving portion is positioned around the end of a first vessel and the end of the first vessel is everted about the outer diameter of the vessel receiving portion such that the inner surface of the vessel is directed outwardly. The end of the second vessel is positioned over the everted end of the first vessel such that the inner surface of the second vessel is disposed against the inner surface of the first vessel. A surgical adhesive is provided and is used to adhere the ends of the vessels together without requiring the application of heat or radiant energy. The handle portion of the vessel support may be removed.

Abstract: Disclosed are compositions, methods, and kits for joining together non-conjoined lumens in a patient's body including vascular lumens.

Abstract: A gastro-intestinal therapeutic device and method includes providing a therapeutic device having a body and an anchoring mechanism. The anchoring mechanism is adapted to resist distal migration of said body in a gastro-intestinal tract. The body is generally configured to a portion of the gastro-intestinal tract and has a first wall portion and a second wall portion. The first wall portion defines a generally sealed membrane. The second wall portion has a scar-forming agent.

Abstract: The invention describes an apparatus and method of use for anchoring two or more body tissue layers to one another. The apparatus includes a plurality of individual anchor segments that are placeable within a body cavity. The segments may assume a first relaxed state wherein the segments are movable relative to each other and alignable along an initial longitudinal axis for initial placement of the apparatus through the body tissue layers. Once placed within the body cavity, the anchor segments are manipulated into a second rigid state with an actuator wherein the segments assume a rigid configuration at a transverse angle relative to the initial longitudinal axis.

Abstract: A method and devices for accomplishing the successful anastomosis of two hollow organ structures are disclosed. The method includes bringing the structures together, applying at least one fastener to hold the structures together and form a connection site, and applying, as alternatives or in conjunction, an adhesive, a wrap and/or a buttress about the connection site. Various examples of fasteners, fastener appliers, adhesives, adhesive initiators and buttress rings also are disclosed.

Abstract: The inventive strip is made of a resorbable material and colonisable by fibroblasts comprises a closure for connecting two ends, thereby securing an anastomosis.

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

Abstract: A coupler is configured to connect a first tubular vessel to an aperture in a second tubular vessel. The coupler includes one or more radially extending members and a substantially nonmetallic tubular member. The substantially nonmetallic tubular member include an outer wall, an inner wall defining a lumen having an open distal end and an open proximal end, and a circumferential ridge encircling the outer wall, the radially extending members extending from the distal end of the tubular member. A method of fabricating a coupler the method including fabricating radially extending members; placing the radially extending members within a mold; injecting a material into the mold; allowing the material to cure to form the coupler; and removing the coupler from the mold. The coupler includes a tubular member having an outer wall, an inner wall defining a lumen having an open distal end and an open proximal end, and a circumferential ridge encircling the outer wall.

Abstract: An implant for bridging a gap in a severed spinal cord or nerve and for promoting nerve regeneration has a matrix comprising a biocompatible, biodegradable, polymeric material. The matrix has a proximal end for connection to a first end of severed spinal cord and a distal end for connection to a second end of severed spinal cord. The matrix includes internal guidance channels extending between the proximal end and the distal end to facilitate rejoining of the first end and the second end of the severed spinal cord. A bioactive agent may be dispersed in the matrix, or disposed in the channels, or included within microspheres in the channels. The channels may be arranged such that guidance channels correspond to spinal cord tracts. Alternatively, guidance channels may be spaced apart at the proximal end of the matrix and converge inward toward the axis of the matrix at the distal end.

Abstract: Minimally invasive techniques utilized in bypass grafting are disclosed. For instance, a method of implanting an end portion of a graft in the body of a patient during a bypass grafting procedure includes the steps of (i) advancing a medical instrument within a circulatory system of said body, (ii) guiding a distal end of said medical instrument out of said circulatory system through an opening defined in said circulatory system after said medical instrument advancing step, (iii) advancing said end portion of said graft within said medical instrument after said guiding step, and (iv) securing said end portion of said graft to a blood vessel of said circulatory system after said end portion advancing step.

Abstract: A body tissue graft for use in a patient includes a frame structure made of a first elastic material, a covering of a second elastic material on the frame structure, the covering substantially filling openings in the frame structure, and a connector connected to the frame structure. Projections are secured to the connector structure. The projections facilitate attachment of the tubular graft in a patient by securing the graft to the body tissue with which the graft is employed. The connector selectively circumferentially expands, and the projections selectively circumferentially expand. This may be done using an inflatable balloon to circumferentially expand the projections. A restraining member may be provided to restrain the projections in a cone shape so that an end of the graft may be used to open an aperture through a side wall of existing body organ tubing, and a portion of the projections may enter the aperture.

Abstract: A new embolic agent, bioabsorbable polymeric material (BPM) is incorporated to a Guglielmi detachable coil (GDC) to improve long-term anatomic results in the endovascular treatment of intracranial aneurysms. The embolic agent, comprised at least in part of at least one biocompatible and bioabsorbable polymer and growth factors, is carried by hybrid bioactive coils and is used to accelerate histopathologic transformation of unorganized clot into fibrous connective tissue in experimental aneurysms. An endovascular cellular manipulation and inflammatory response are elicited from implantation in a vascular compartment or any intraluminal location. Thrombogenicity of the biocompatible and bioabsorbable polymer is controlled by the composition of the polymer. The coil further is comprised at least in part of a growth factor or more particularly a vascular endothelial growth factor, a basic fibroblast growth factor or other growth factors.

Abstract: Methods and apparatus for passing attachment apparatus (e.g., connector devices, staples, etc.) or connector material (e.g., suture thread, wire, cord, filament, monofilament, etc.) into or through the wall of a luminal anatomical structure (e.g., a blood vessel or other anatomical conduit) for the purpose of; i) closing the lumen of the anatomical structure, ii) forming an anastomotic junction between separate anatomical structures (or between approximated segments of the same anatomical structure), and/or iii) attaching an article (e.g., an endoluminal, extraluminal or transluminal graft) or other apparatus to the wall of the anatomical structure.

Abstract: A stent suitable for implantation in myocardial tissue to enhance perfusion therein may include a tubular member having first and second ends and a lumen. The first end of the stent may be configured to pierce myocardial tissue and the lumen may be configured to be placed in flow communication with a coronary vessel. The stent may further include a means for retaining the tubular member within the myocardial tissue. A method for implanting the stent may include positioning the first end of the stent at a desired implantation site and applying force to the second end of the stent to implant the stent within the myocardial tissue. The method may further include engaging the means for retaining with the myocardial tissue to retain the stent in position.

Abstract: A temporary biocompatible stent and method for visceral anastomosis. The stent is provided with integral means for maintaining the structural stability of the stent while providing substantial flexibility. The method comprises fitting the luminal stumps of the viscus over either end of a stent of the invention, and joining the ends of each stump together. A short time after completion of the anastomosis, the stent dissolves and is absorbed safely into the body. The stent and method can be beneficially used in laparoscopic or more invasive traditional surgical procedures. The stent and method are particularly well suited for anastomosis of the bowel.

Abstract: A method and apparatus for performing prosthetic arterial graft surgery is disclosed. The apparatus for facilitating prosthetic arterial graft surgery includes a tubular element having a first end and a second end exposing the inside volume of the tubular element, the first end and the second end for anastomotic coupling to an artery. The apparatus further includes an enclosure coupled to a side of the tubular element, wherein an inside volume of the enclosure is continuous with the inside volume of the tubular element and an access valve coupled to the enclosure, allowing for insertion of fluid into the enclosure. It is determined whether the prosthetic arterial graft is hemostatic by insertion of fluid into the tubular element via the access valve and inspecting for leaking of the fluid at the anastomoses.

Abstract: Medical devices, and in particular implantable medical devices, may be coated to minimize or substantially eliminate a biological organism's reaction to the introduction of the medical device to the organism. The medical devices may be coated with any number of biocompatible materials. Therapeutic drugs, agents or compounds may be mixed with the biocompatible materials and affixed to at least a portion of the medical device. These therapeutic drugs, agents or compounds may also further reduce a biological organism's reaction to the introduction of the medical device to the organism. In addition, these therapeutic drugs, agents and/or compounds may be utilized to promote healing, including the formation of blood clots. Various materials and coating methodologies may be utilized to maintain the drugs, agents or compounds on the medical device until delivered and positioned.

Abstract: A bioabsorbable material such as a terpolymer of poly-(L-lactide/D-lactide/glycolide). The material may consist of 85 molar percent L-lactide, 5 molar percent D-lactide, and 10 molar percent glycolide. The material may have a heat of fusion of about 15-25 J/G, tensile strength retention at 26 weeks of incubation of at least about 50%, and tensile strength retention at 52 weeks of incubation of at most about 25%. The material may be used in implantable devices such as bone fixation devices.

Abstract: A resorbable, flexible implant in the form of a continuous macro-porous sheet is disclosed. The implant is adapted to protect biological tissue defects, especially bone defects in the mammalian skeletal system, from the interposition of adjacent soft tissues during in vivo repair. The membrane has pores with diameters from 20 microns to 3000 microns. This porosity is such that vasculature and connective tissue cells derived from the adjacent soft tissues including the periosteum can proliferate through the membrane into the bone defect. The thickness of the sheet is such that the sheet has both sufficient flexibility to allow the sheet to be shaped to conform to the configuration of a skeletal region to be repaired, and sufficient tensile strength to allow the sheet to be so shaped without damage to the sheet. The sheet provides enough inherent mechanical strength to withstand pressure from adjacent musculature and does not collapse.

Abstract: A subcutaneous cover for insertion within a body of a user is disclosed. The cover is adapted to extend over at least a portion of a medical device disposed within the body of the user, and wherein the cover is dissolvable in the body of the user. Further, a method of subcutaneously inserting the cover into the body is also disclosed.

Abstract: Pharmaceutically acceptable hydrogel polymers of natural, recombinant or synthetic origin, or hybrids thereof, are introduced in a dry, less hydrated, or substantially deswollen state and rehydrate in a physiological environment to undergo a volumetric expansion and to affect sealing, plugging, or augmentation of tissue, defects in tissue, or of organs. The hydrogel polymers may deliver therapeutic entities by controlled release at the site. Methods to form useful devices from such polymers, and to implant the devices are provided.

Abstract: The present invention is directed to novel sulphated compounds of hyaluronic acid and derivatives thereof, optionally salified, wherein the glucosamines are partially N-sulphated or partially N-sulphated and partially or totally O-sulphated in position 6. The compounds of the invention have anticoagulant and antithrombotic activities and are useful in the preparation of pharmaceutical compositions and biomaterials and in the production of coatings for biomedical objects.

Abstract: A syringe pump has a plunger head retainer with two retainer arms mounted on shafts extending parallel to the syringe axis. Each shaft carries a gear, which is engaged by common gear wheel mounted on a threaded shaft. Initially, the shaft is rotated to displaces the gear and hence the retainer arms axially forwardly, and thereafter swing the retainer arms outwardly to an open position. After the syringe has been loaded in the pump, the plunger head retainer is driven forwards until a pad coupled with a force sensor detects contact with the head. This causes the retainer arms to be swung in across the forward side of the plunger head and to be pulled rearwardly against the plunger head. The pump then reduces the force applied by the retainer arms to ensure that the force sensor can respond to force on the plunger during expulsion of liquid from the syringe.

Abstract: The present invention relates to a surgical fastener or device (implant) formed in the shape of an arrow comprising a shaft with a proximal (first) portion having a blunt end and tapered form, such that the proximal portion is broad at its blunt end and tapers in the direction of a distal (second) portion of the shaft, the distal portion having protrusions and a pointed end, wherein the tapered form of the proximal portion and the protrusions of the distal portion are configured to lock the implant in a position inside a soft and/or tough tissue according to the use of the implant. The implant may be manufactured of a polymer or a polymeric compound which is substantially (bio)absorbable (resorable) after implantation in tissue and contains an oriented reinforcing structure or the like of a polymer or polymeric compound or ceramic bioactive glass compound.

Abstract: The present invention is directed to crystalline, absorbable block/segmented copolymers which are the reaction product of a linear prepolymer which is a polytrimethylene dicarboxylate of succinic, glutaric, or adipic acid and either glycolide, 1-lactide, or mixtures thereof. Preferably the prepolymer is preliminarily end-grafted with a further monomer such as trimethylene carbonate or &egr;-caprolactone. The crystalline copolymers of this invention are tailored for fabrication into several forms of absorbable biomedical devices including monofilament sutures.

Abstract: A surgical fastening system includes a fastener having a plurality of individual fastener pairs each having a piercing element with a pin that pierces the tissue to be repaired and a receiver portion that interlocks with the pin of a corresponding piercing element. A fastener dispenser holds the piercing elements and receiver elements in relative juxtaposition and in a predetermined geometric configuration, such as a circle. After the tissues to be joined are positioned between the piercing and receiving elements held in the dispenser, the dispenser is adjusted to draw the elements together capturing the tissue therebetween. The dispenser then pushes the piercing elements through the tissue and into the receiving elements causing the elements to interlock. Because the anastomosed junction is formed by a plurality of independent pairs, the junction retains flexibility. When used to anastomose a tubular organ, the fastener allows radial expansion of the organ permitting peristalsis.

Abstract: The present invention provides an implant device and an associated method for interconnecting human vessels rapidly, safely and in a minimally invasive manner. The device comprises a first segment, a second segment, and a flow opening along the periphery of the two connected segments. The first and second segments are bendable for easy insertion into an incision made within each vessel. Upon release, each bendable segment subsequently conforms to the interior walls of a vessel to provide a sealing contact along the contact surface of the segment inserted within. The flow opening provides fluid interconnectivity between the vessels connected by the implant device.

Abstract: The present invention provides implantable devices and associated methods forinterconnecting human vessels in a side-to-side or an end-to-side arrangement rapidly, safely and in a minimally invasive manner. The devices comprises at least a first segment, a second component, and a flow opening between the at least one segment and the second component when operatively used. The first segment is flexible and has physical and mechanical properties which allow it to be easily inserted into a vessel, to conformably seal with the inside wall of the vessel and to be resistant to dislodging from the vessel. The second component may comprise a second segment having the same or a similar configuration as the first segment or may be a tubular member which extends from the first segment. The first and second segments are flexible for easy insertion into an incision made within the side of each vessel.