Abstract: Device, systems and methods are provided to isolate aneurysms, particularly at bifurcations, while maintaining adequate blood flow through nearby vessels. These devices are deliverable to a desired target area and maintain position in a desired orientation so as to occlude flow in some aspect while allowing flow in others. In addition, devices, systems and methods are provided to occlude blood vessels, such as endoleaks, to improve the isolation of aneurysms.

Abstract: A device for fixating a gastrointestinal device may include a band of material that may be wrapped around the gastrointestinal tract, for example, by wrapping the band around the outside of the stomach or wrapping the band in such a way that it is integrated into and/or with the stomach tissue. In this illustrative embodiment, the band restricts the stomach such that the stomach lumen is constricted and/or the stomach is restricted from expanding beyond what the band will allow.

Abstract: An apparatus for providing a restriction and sensing an associated operational parameter, comprises a restriction device and a sensing device. The restriction device is configured to be secured around a portion of an anatomical structure. The restriction device is operable to form a restriction within the anatomical structure. The sensing device is configured to sense a parameter associated with operation of the restriction device. At least a portion of the sensing device is configured to be positioned adjacent to tissue of the anatomical structure. The restriction device may comprise a gastric band, among other things. The sensing device may comprise a pressure sensor, among other things.

Abstract: Devices, methods and kits for restricting a portion of a GI tract by tightening tissue are provided. The devices, methods and kits can be used to treat GERD or obesity. The devices, methods, and kits do not require the formation of plications in tissue walls and may result in faster application, reduced surgical trauma, reduced risk, and reduced cost. The devices comprise a plurality of tissue-engageable anchors coupled to a tether. Each anchor is secured to a tissue wall of the GI tract. The anchors are secured to the tissue wall in a manner that may minimize tissue damage. The tether is configured to be cinched to draw the anchors together, which in turn draws the tissue secured to the anchors together, thereby tightening tissue to restrict a portion of the GI tract.

Abstract: A method of arresting blood vessels in soft tissue at a predetermined location relative to an excision location where a part of the soft tissue is to be removed, is described. The method comprises securing at least one clip to a retention means of at least one of a pair of fingers of forceps. The fingers of the forceps are then positioned on a respective side of the tissue at the predetermined location. The fingers are displaced towards one another to cause the at least one clip to penetrate the soft tissue and form a clamp whereby to clamp the blood vessels at the predetermined location. Thereafter an excision is made to remove the portion of the soft tissue and the fingers of the forceps are withdrawn with the clamp retained engaged by the clip. The clip, device and method achieve a substantially bloodless and painless surgical procedure. The clip is constructed from bioabsorbable polymeric material and may be impregnated with an analgesic, anesthetic, an antibiotic or an anti-inflammatory substance.

Abstract: A device for reducing the volume of a hollow body organ includes a tissue port and a plurality of fasteners. The fasteners may be coupled to a flexible filament, such as a suture, which is tensioned to constrict the hollow body organ to achieve volume reduction.

Abstract: A gastric ring includes a band that surrounds the wall of the stomach of a patient, and structure that makes it possible, after implantation, to modify the cross section of the opening delimited by the ring.

Abstract: A laparoscopic band or non-adjustable clamp is placed about the greater curvature of the stomach in a vertical orientation. The band or clamp completely compartmentalizes the stomach between a small pouch and the fundus. The fundic part of the stomach is excluded from nutrients and creates a long narrow channel where the food travels. A small passage at the level of the antrum allows gastric juices to empty from the fundic areas.

Abstract: A novel umbilical cord clamp and a combined umbilical cord clamp and cutter are provided for clamping and cutting umbilical cords in one motion. The cutter comprises two shells joined by a longitudinal hinge. A transverse blade is mounted in one shell, and a cutting support is mounted in the other shell across from the blade. One or more removable clamps may be engaged with the shells to be removable from the shells after cutting. Alternatively, a self-winding or plastically deformable band may be engageable with the shells. The cutter and its associated removable clamp(s) may be coordinated with an identifier, such as a color, number, or letter. Blood sampling and diagnostic features may be included with the cutter. The removable clamps may have an openable closure.

Abstract: A system and method forms a gastric reduction pouch within a stomach associated with an esophagus. The method includes the steps of delivering, down the esophagus, a substantially planar annular member into the stomach, drawing stomach wall tissue to a juxtaposed relation with the annular member; and securing, to the annular member, the stomach wall tissue juxtaposed to the annular member.

Abstract: A method for treating eating disorders comprising the steps of generating a neuro-electrical satiety signal that substantially corresponds to a neuro-electrical signal that is generated in a body and produces a satiety effect in the body, constricting the stoma of the stomach, and transmitting the neuro-electrical satiety signal to the subject.

Abstract: Devices and methods for transgastric surgery are provided. In one aspect, a surgical device is provided that includes an elongate member having a proximal end, a distal end, and an inner lumen extending through at least a portion thereof that is adapted to receive a fluid flow therethrough. A selectively expandable member is coupled to the distal end of the elongate member and is adapted to receive fluid from the elongate member. A mesh is disposed around at least a portion of the expandable member. The mesh has a pre-shaped configuration, and at least a portion of the mesh is adapted to be operatively positioned to occlude a portion of a hollow organ.

Abstract: Methods and devices for providing a minimally-invasive placement of a mechanical structure for reducing the volume of a hollow body organ. Intragastric bands may be secured within the hollow body organ and then reduced in diameter to form a stricture within the hollow body organ. The strictures may be placed anywhere within the hollow body organ, and more than one stricture may be formed within the hollow body organ.

Abstract: A laparoscopic surgical clamp for use in minimally invasive surgical procedures includes an elongated shaft, a first set and a second set of double jaws connected to distal end of shaft and moveable relative to one another, and a double handle assembly operatively connected to at least one of the double jaws. The double jaws include an opened position in which the double jaws are separated and substantially parallel to one another and a closed position in which the double jaws are adjacent and substantially parallel to one another. At least one articulation segment is located on each jaw such that the double jaws may be positioned in a U- or V-shaped configuration when in an articulated position. A plurality of fenestration is located on at least one jaw of the double jaws to allow suturing through the double jaws to secure the surgical clamp to the organ tissue.

Abstract: A perforation suture clip is used in combination with an endoscope and sutures a perforation occurring in a digestive tract, and includes: a rod portion whose two ends are sharpened; a hook portion that is bent back from one end side of the rod portion at a predetermined opening angle towards the other end side of the rod portion; and a traction portion that is fixed to the other end side of the rod portion and drags the other end side of the rod portion.

Abstract: Surgical fasteners (100) are disclosed for terminating flow of fluid through a body lumen, including an outer barrel (102) having an annular side wall (106) having at least a pair of radial slots (110) formed therein, and an inner barrel (104) rotatably and concentrically coupled within the outer barrel (102). The inner barrel (104) has an annular side wall (118) including a radial slot (122) formed therein corresponding to each radial slot (110) formed in the outer barrel. The surgical fastener (100) has an open position in which the radial slots (110) of the outer barrel (102) are radially aligned with the corresponding radial slots (122) of the inner barrel (104) and a closed position in which the radial slots (110) of the outer barrel (102) are out of radial alignment with the corresponding radial slots (122) of the inner barrel (104) and constrict the body lumen at two locations along the length thereof. An applier (200, 500, 600) is provided for applying the surgical fasteners.

Abstract: A locking device has a band provided with a locking element on its one end, a housing, a rocker turnably movable relative to the housing and having an edge which in a closed position of the device applies pressure to the band and stops the band from movement, the locking element provided on the end of the band being engageable with the housing, a first unit for turning the rocker and releasing the pressure on the band so that the band is released and can be moved but the locking element can not disengage from the housing, and a second separate unit which, upon release of the pressure on the band and application of an action to the second unit by a user, release the locking element from the housing in a next step so as to disengage the element from the housing and to open the locking device.

Abstract: An introducer device comprising: an introducer needle having a proximal end and a distal end and a handle having a needle receiving end. The handle can be adapted to receive said distal end of said introducer needle such that said introducer needle is selectably detachably coupled to said handle. A connector for attachment to an implant strip can have an arm having a hole therethrough and an introducer needle including a connection portion having a barb. It can comprise a central portion; a first arm pivotally mounted to the central portion and having a first projection and a second projection extending therefrom. A second arm can be pivotally mounted to the central portion and having a first hole and a second hole defined therein. The first and second holes can be positioned so that when the first arm pivots toward the second arm, the first and second projections are received in the first and second holes. A tube portion can extend from said central portion and define a tube aperture therein.

Abstract: An improved fluid port for use in an adjustable gastric banding system that can be laparoscopically-implanted around the upper stomach of an obese patient as part of a procedure to help in weight reduction. The improved fluid port is coupled to a conventional constriction collar of the banding system by way of bio-compatible fluid tubing. The fluid port includes a rigid liner having a needle cannula receiving fluid reservoir at one end thereof at which fluid is added to or withdrawn from the constriction collar and a reservoir extension at the opposite end to be mated to the fluid tubing. The fluid reservoir and the reservoir extension are aligned with one another at an angle so as to be oriented following implantation (e.g., below the xiphoid bone where layers of fat and muscle are minimal) to be quickly and easily located by palpating the patient's skin at the bottom of the sternum immediately below the xyphoid process.

Abstract: A system for securing an implantable apparatus to a mammal includes a mount including a base portion having a plurality of holes dimensioned to receive rotationally-driven fasteners, each fastener comprising a helical portion having a tip configured for tissue penetration, the mount configured to secure the implantable apparatus relative to tissue of the mammal upon driving the fasteners into the tissue. The system further includes a fastening tool configured to rotationally drive the helical portion of the fasteners into the tissue. The mount may be secured to the fascia covering the sternum via a subcutaneous securement method, or it may be attached to the intra-abdominal wall, behind the sternum, or it may be attached to the sternum directly via bone screws or the like.

Abstract: Devices, systems and methods for temporarily reducing or abolishing blood flow by occluding blood vessels are provided. A blood vessel-occlusion device embodying features of the invention includes a deployable pressure-applying member with a location sensor, and an applicator. The location sensor is configured to detect a blood vessel, which may be occluded by compression from the pressure-applying member. A pressure-applying member may be released from the applicator, with blood-vessel compression maintained after release. The applicator is configured to engage a guide, such as a tenaculum, to aid in the placement and operation of the applicator. A pressure-applying member may also engage the guide. The invention finds use in, for example, treating uterine disorders and conditions which may be treated by occlusion of the uterine arteries, such as uterine fibroids, dysfunctional uterine bleeding, post-partum hemorrhage, and bleeding associated with caesarian section.

Abstract: A surgical clip dispenser arranged to hold a plurality of surgical clips for retrieval by a clip applier is provided. The dispenser in one aspect includes a clip housing with a plurality of slots each adapted to hold a plurality of surgical clips and is biased for rotational movement. A regulator substantially encompassed by the clip housing in one position prevents rotational movement of the clip housing and in another position permits rotation of the clip housing.

Abstract: A surgical ligation clip capable of remote deployment through a catheter.

Abstract: Improvements to external stents to render incompetent venous valves competent are disclosed. The device is an inelastic bio-compatible cuff (1) that encircles the venous valve cusps (15) decreasing the internal diameter of the vein wall (11) to allow apposition of the cusps (15) and create competence. The device may be calibrated to known diameters to create competence for different phenotypes. The different diameters are indicated by holes (2, 3, 4) in the body (1). The buckle attachment (6) allows the body of the device to become conical or inverted to become pyramidal as appropriate. The wide buckle (5) allows the device to become elliptical at smaller diameters. The angle of the notches (10) in the device is approximately 15°, which allows better overriding at the sapheno-femoral junction resulting in better competence of the valve.

Abstract: Tool arrays for biomedical surgery where the tools consist of layered polymer micromuscles arranged to induce geometrical changes and movements via an electrochemically induced change of volume in at least one polymer layer. The tool or tool arrays are mounted on a carrier having the form of a needle being inserted into a cannula/catheter through which the tools can be electrically actuated via external means to induce a mechanical movement to act upon biological structures.

Abstract: Devices, tools and methods for occluding fluid flow between two walls of tissue in a patient. Two walls of tissue are compressed together with sufficient compressive force to prevent fluid flow between the two walls, while ensuring that the compressive force is not so great as to cause tissue necrosis. The devices, tools and methods may be carried out using minimally invasive surgical techniques, such as in reduced-access surgical sites. Devices, tools and methods are provided for occluding an atrial appendix.

Abstract: The invention is directed to a uterine artery clamp and the relatively non-invasive treatment procedure utilizing this clamp. The uterine clamp includes a clamping member having a jaw with tissue-contacting surfaces for applying pressure to target tissue and a stabilizing member which is configured to be inserted into the patient's uterine cervical canal. The clamp may be provided with elongated handles to manually adjust the spacing between the jaw and stabilizer and thereby apply pressure to a uterine artery beneath a bundle of tissue held between the jaw and stabilizer. Uterine clamps embodying features of the invention by be used in procedures for treating uterine disorders such as fibroids, DUB, PPH and the like.

Abstract: A polymeric, surgical clip having first and second curved legs with each having a pair of opposing side surfaces joined at their proximal ends by a flexible hinge section and movable from an open position to a closed position for clamping a vessel between curved opposing inner surfaces. The first leg terminates at its distal end in a female locking member, and the second leg member terminates in a male locking member complimentary to the female locking member such that when the first and second leg members are moved from an open position to a closed position about the hinge section the male member is lockingly engaged in the female locking member. The clip has at least one cutting guide extending outward from and disposed along at least a portion of the length of at least one of the side surfaces of at least one of the first and second legs. The cutting guide aids in cutting the ligated tissue a safe distance from the clip such that a tissue cuff is formed.

Abstract: A surgical clip having a sliding state and a crimped state is adapted for use in a surgical procedure initially to slide along suture ends to an operative position and ultimately to crimp the suture ends at the operative position. a sub straight, bendable between the sliding state and the crimped state carries at least one coating having either lubricious or traction enhancing properties. A second coating can be added to form a coating laminate with the outer coating having lubricious properties facilitating the sliding state and the inner coating having traction enhancing properties facilitating thee crimped state.

Abstract: The device is formed from a multi-stranded micro-cable having a plurality of flexible strands of a shape memory material and at least one radiopaque strand. The strands can be made of a shape memory nickel titanium alloy, that is highly flexible at a temperature appropriate for introduction into the body via a catheter, and that after placement will take on the therapeutic shape. The radiopaque strand can have a core strand with a plurality of intermittently spaced apart enlarged radiopaque portions that may be a plurality of beads of radiopaque material spaced apart and mounted on the core strand, or a plurality of coils intermittently wound about and spaced apart on the core strand. A polyhedral occlusive device is also provided, adapted to be inserted into a portion of a vasculature for occluding a portion of the vasculature, for use in interventional therapy and vascular surgery.

Abstract: An implantable device including a supporting member, such as a ring, or series of rings, and an impeding member that is used to adjust the effective area of the created orifice after implantation. The rings may hold pleats of gastric tissue in place around their circumference to create a reinforced constriction within an organ. The rings may be attached to one another with folds or pleats of tissue held between them. If the organ is a stomach, the constriction is positioned such that a chamber of a predetermined volume is created proximal to the constriction, leaving a narrow opening or stoma to the remainder of the stomach's volume distal to the constriction. At least one of the rings is adapted to have an impeding member that may be endoscopically adjusted in order to alter the size of the effective orifice area of the opening or outlet. The occluding member may be a ball suspended by a suspension line connected to opposing sides of the supporting member.

Abstract: Devices and methods for achieving hemostasis and leakage control in hollow body vessels such as the small and large intestines, arteries and veins as well as ducts leading to the gall bladder and other organs. The devices and methods disclosed herein are especially useful in the emergency, trauma surgery or military setting, and most especially during damage control procedures. In such cases, the patient may have received trauma to the abdomen, extremities, neck or thoracic region. The devices utilize removable or permanently implanted, broad, soft, parallel jaw clips with minimal projections to maintain vessel contents without damage to the tissue comprising the vessel. These clips are applied using either standard instruments or custom devices that are subsequently removed leaving the clips implanted, on a temporary or permanent basis, to provide for hemostasis or leakage prevention, or both. These clips overcome the limitations of clips and sutures that are currently used for the same purposes.

Abstract: A surgical method of treating morbid obesity via bariatric procedures, carried out endoluminally and transluminally using endoscopic devices that are introduced through natural body openings without the necessity of creating any incisions in the abdominal wall.

Abstract: A torsional ligation clip applier and method of use for endoscopic or laparoscopic vessel occlusion procedures is provided. The ligation clip includes a hub portion and ligation arms for occluding a vessel. Ligation arms are independently rotatable about a common axis that is parallel to the longitudinal axis of the ligation arms. The ligation arms are biased in a first position by a biasing mechanism. The ligation arms of the clip are rotatable through at least one of a plurality of positions wherein it has a larger diameter than an access device. An applier receives at least one ligating clip in a first position and delivers the ligating clip to a vessel in a second position. Occlusion of the vessel occurs when one of the ligation arms is rotated into a third position.

Abstract: An implantable device comprising: a stepper motor; a moveable member, moveable by the stepper motor; and an oscillator, wherein the oscillator is influenced by a signal derived from or supplied to the stepper motor to enable information on the moveable member to be fedback to an external controller by passive telemetry.

Abstract: A surgical tool or applier facilitates laparoscopic or endoscopic implantation through a single bodily tissue lumen of an anastomotic ring device for forming a hollow rivet type of attachment between tissue lumens. In addition to forming a puncture between apposite tissue walls at the anastomosis site, the applier assists or wholly actuates the anastomotic ring device and is retracted to deploy the actuated ring device. Illumination incorporated into a distal portion of a cannula enables confirmation of deployment.

Abstract: A grasper is provided having a handle with an elongated shaft secured thereto. First and second jaw members with opposed clamping surfaces are secured to the shaft, with one jaw member being slidably secured with respect to the other jaw member. The jaw members are relatively movable by an actuator between an open position and a closed position. A resilient member is associated with at least one of the first or second jaw members or the actuator limits the force exerted on tissue held between the clamping surfaces of the jaws when the jaws are in the closed position. The jaws are preferably, but not necessarily, pivotal relative to the elongated shaft by remote actuation.

Abstract: The invention relates to the production of a vertical gastric reservoir for the surgical treatment of morbid obesity. The reservoir consists of a clamp having two plates articulated at the lower end thereof and an automatic closing system in the upper part thereof, reinforced with a sealing system. Both plates are provided with two extensions (one at each end of the instrument) on the right-hand edge thereof. Both extensions are provided with two openings that are used to fix the instrument to the stomach wall. Application of the instrument and the technical solution provided are as follows: the substitution of metal staples which are subsequently eliminated in between 15% and 20% of patients and which result in failure of the vertical band gastroplasty operation. The instrument could also be used for producing small gastric reservoirs used for gastric bypass with minor curvature instead of metal staples.

Abstract: A surgical clip applier for use in closing wounds under the microscope in small blood vessels modifies a well-known clip applier system to make more steady and reliable the application of very small clips during surgery on a scale of vessel size of 2 mm in external diameter and smaller. The known device is modified internally so as to be capable of receiving a flexible remote actuation device which can be a cable release such as used for a camera shutter, or which can be a flexible hydraulic or pneumatic line as a force-transmitting device. Thus, the surgeon can hold the clip applier very steadily at the site desired without contracting any intrinsic muscles while the cable release is depressed by another person, or with the surgeon's other hand, or with a foot pedal.

Abstract: A ligating band according to the present invention comprises an elastomeric layer and an inner drug releasing layer. The inner drug releasing layer includes a therapeutic agent, for example a chemotherapeutic agent for treating a mucosa, polyp or other growth. A ligating band according to the present invention also may include an inner diffusion barrier disposed between the elastomeric layer and the inner drug releasing layer, with the elastomeric layer and the inner drug releasing layer each contacting the inner diffusion barrier.

Abstract: A vascular occlusive device, such as an embolic coil, having thrombogenic fibers extending from the coil and having an outer barrier which encapsulates and flattens the fibers along the sides of the embolic coil for preventing activation of the coil until the outer barrier has been dissolved, or removed, from the embolic coil.

Abstract: A vascular occlusive device, such as an embolic coil, having thrombogenic fibers extending from the coil and having an outer barrier which encapsulates fibers extending from the embolic coil for preventing activation of the fibers until the outer barrier has been dissolved, or removed, from the embolic coil.

Abstract: The present invention relates to an aneurysm stent having a base and connector. The base has a vessel facing side and an aneurysm facing side, and is shaped to cover an aneurysm sufficiently. The connector is coupled to the aneurysm facing side of the base such that when deployed the connector is adapted to extend partially into the aneurysm to anchor the base about the aneurysm and alter flow into the aneurysm. Further, the stent can be used as a delivery mechanism to deliver growth factor.

Abstract: A surgical ring, designed to be implanted around biological organs comprising a pouch or a duct, so as, on the one hand, to form a closed loop between these two extremities (1, 2), thus forming a first (1) and a second (2) extremity and, on the other hand, to reduce the diameter of the opening of the organ when it is tightened by the ring, the ring including a system for reversibly controlling the variation in its diameter. The system also includes a flexible filiform element (4), inserted longitudinally with possibility of sliding into the material constituting the body of the ring between the first (1) and second (2) extremities, so as to define a fixed portion (5) connected to the first extremity (1) and a free portion (7) associated with an actuator (8) mounted on the ring near the second extremity (2).

Abstract: Methods and devices for blocking orifices and occluding cavities within a patient are provided. The device in one variation comprises first and second tubular members attached to a collapsible sealing element. The device can be placed through an orifice and the collapsible sealing element can be collapsed to seal the orifice. An embolic may be introduced distal to the sealing element to occlude a cavity. The device may incorporate a locking mechanism which can be engaged to lock the sealing element into the collapsed position. The device may incorporate a valve to prevent flow through the tubular members, for example to prevent egress of the embolic from a cavity. The device can be detached to provide a permanent seal of the orifice, and can retain the embolic within the cavity. The device may be used in conjunction with a stent or other retention device to assist the sealing element in maintaining the seal.

Abstract: A ligating apparatus includes an introducing tube which can be inserted in a living body cavity, a manipulating wire inserted in the introducing tube in such a manner that the manipulating wire can freely advance or retreat, a clip which is directly joined to a tip end of the manipulating wire, which has a holding portion formed in a tip end of an arm portion extending from the base end, and which has an extending/opening property, and engaging structure disposed in at least one of the base end of the clip and the tip end of the manipulating wire, wherein at least one of the engaging means is deformed and releases engaging of the clip and the manipulating wire, when the clip engages with the tip end of the introducing tube, and a force for detaching the base end of the clip from the tip end of the manipulating wire is applied.

Abstract: The present invention relates to a method of displacing an area of the macula of an eye, including the steps of placing a substance below the surface of the retina, folding the retina to form a folded portion of the retina, and affixing the folded portion, so that the folded portion substantially maintains a folded shape.

Abstract: The ligation clip applicator and ligation clip design are provided which are particularly applicable to placement of a surgical ligation clip during a laparoscopic surgical procedure. The clip includes a support member and a clamping arm having enlarged portions thereon. The applicator device has a magazine including first and second longitudinally extending partially closed channels within which the enlarged portions of the support member and the clamping arm are received with the clip held in an open position. First and second articulated jaws are attached to the magazine and have first and second channel extensions therein aligned with the first and second channels of the magazine, so that a clip can be received from the magazine in the jaws with the first and second enlarged portions of the support member and the clamping arm being received in the first and second channel extensions of the jaws. The channel extensions include first and second releasing openings.

Abstract: The method of the invention includes accessing a juncture of an esophagus and a stomach of the patient on a distal side of a diaphragm. The esophagus and a fundus of the stomach intersect at a cardiac notch located at an original cardiac notch position. A reducing element is placed at the junction with the reducing element selected to reposition the cardiac notch to a position more distal to a lower esophageal sphincter of the patient.

Abstract: A constriction device that constricts body tissue includes fixation structures for fixing the device on constricted body tissue. The device includes an elongated sleeve including an inner surface and opposed opened ends. The device is formed from expandable or elastic material so that when in an expanded condition, body tissue to be constricted may be received therein and thereafter, when released from the expanded condition, the body tissue is constricted by the device. The fixation structures include a plurality of fixation elements on the inner surface of the sleeve that grasp the body tissue upon release of the sleeve from the expanded condition to fix the device on the constricted tissue.