Abstract: Methods and devices for partitioning or plicating a region of a hollow body organ are described herein. These methods and devices relate generally to medical apparatus and methods and more particularly to devices and methods for affecting a change in the function of a hollow body organ, particularly a stomach, intestine or gastrointestinal tract. These changes can include reducing the volume capacity of the hollow body organ, disrupting or altering the normal function of the organ, functionally excluding certain sections of the organ either by affixing adjacent tissue or excising certain regions, or affecting or correcting the response of the organ to naturally occurring stimuli, such as ingestion.

Abstract: A device for generating an artificial constriction in a gastrointestinal tract includes a band, which can be placed annularly about a particular portion of the gastrointestinal tract, having a fillable hollow volume, and a closure device for connecting end regions of the band placed annularly about the portion of the gastrointestinal tract. The closure device is a safety closure, which, at a tear-off tension exceeding a limit value, opens free of destruction, and which can be closed again. This limit value of the tear-off tension is in the range between 20 and 60 N, and preferably between 30 and 50 N.

Abstract: A surgical tool for safely introducing a gastric band into a patient's abdomen is provided. The instrument includes an inner rod slidably and coaxially disposed within a support tube. The inner rod includes a gastric band releasably secured thereon. Distal movement of the inner rod into the support tube exposes said gastric band.

Abstract: A vascular clamp and a method for temporarily occluding a vessel. The vascular clamp comprises two jaws, two handles, and a pivoting point. A biasing mechanism is positioned between the handles for biasing the handles apart so that a closing force is imparted along the length of the jaws. The pivoting points pivotally connect the jaws together and are also configured to allow one jaw to be lifted relative to the other jaw. The method of temporarily occluding a blood vessel comprises the steps of providing a vascular clamp as described above and positioning the clamp about a blood vessel.

Abstract: An arterio-venous graft (16) is provided with a constriction device (20) near its arterial end. The constriction device (20) is used to reduce the flow through the AV graft under normal conditions and to relieve the constriction when high flow through the AV graft is required, such as for vascular access for hemodialysis.

Abstract: A clip device for hemostasis includes an introducing tube (outer sheath) insertable into a body cavity. An operating wire is slidably inserted into an inner sheath, which in turn is separately advanceable and retractable within the outer sheath (introducing tube). The operating wire has a distal end portion and a retainer attached to the distal end portion of the operating wire. The clip device further includes a clip having a proximal end portion and at least three arm portions extending from the proximal end portion and provided with a tendency to open. A first retainer is attached to the distal end of the clip and is matingly received by a second retainer provided on the operating wire. A clip sliding ring is provided for closing the arm portions of the clip. Methods for delivering the clip and for causing hemostasis are also provided.

Abstract: A surgical instrument assembly for the treatment of hemorrhoids includes an anoscope and a hemorrhoid occlusion device. The anoscope includes a hollow body closed at a distal end and at least partially open at a proximal end to define a longitudinal channel. The hollow body has a sidewall provided with a window spaced from the distal end and the proximal end. A shutter member is slidably attached to the hollow body for selectively covering the window during an insertion operation and for opening the window to allow hemorrhoidal tissues to protrude through the window into the anoscope. The hemorrhoid occlusion device includes an instrument shaft provided at a distal end with two jaws, at least one of the jaws including a C- or U-shaped clamping member movable alternately away and towards the other of the jaws for clamping and occluding hemorrhoidal tissues protruding through the window into the anoscope.

Abstract: A clip device for holding a living tissue, wherein a clip operating force adjustment portion is provided with a hold member placed in a state of relatively increasing a ratio of a clip closing force to close clip hands to a clip opening force to expand the clip hands of a clip when operating the clip.

Abstract: A clamp has a handle assembly and a gripping assembly having a pair of jaws that can be opened and closed to grip an element, the pair of jaws being parallel to each other when they are opened and when they are closed. The clamp also has a flexible shaft having a proximal end that is operatively coupled to the handle assembly and a distal end that is operatively coupled to the gripping assembly.

Abstract: An aneurysm embolic device is disclosed for use in occluding the flow of blood within an aneurysm. The aneurysm embolic device includes an expandable sealing member having a circular joining member and reinforcing spokes which give the sealing member a slightly cupped configuration. The embolic device also includes an occlusive member carried by the expandable sealing member. When the aneurysm embolic device is deployed within the aneurysm, the sealing member expands and the occlusive member fills the aneurysm preventing the flow of blood within the aneurysm.

Abstract: An aneurysm clip (1) is provided with two arms (2, 3) which are resiliently pivotable towards each other and carry at their free end clamping bars (12, 13) which are resiliently clamped against each other by the spring force of the arms, with outwardly curved sections of the arms adjoining the clamping bars and jointly forming a receiving space (10) for a vessel (11). In order to improve the safety of the application and the possibility of varying the application of the aneurysm clip, the clamping bars protrude from the arms towards both sides and thereby project laterally on both sides over the width of the arms in the outwardly curved sections.

Abstract: A clamp is positioned in a fleshy area of a person's hand between the thumb and index figure. The clamp has a top and bottom arm with a thumb screw to close a gap between the arms over the fleshy area of a person's hand and is left in place for two to three minutes or until the person's headache is relieved. Thereafter, the clamp is removed and stored for future use.

Abstract: A surgical ring (1) designed to be implanted around (a) biological organ(s), the ring (1) being formed by a flexible band (2) including a first and second extremity (3, 4), the flexible band (2) being designed to be closed near its two extremities (3, 4) by a closure system so as to form a closed loop featuring an internal contact surface (2A) external 10 surface (2B). The closure system includes a means of encircling (5) that is integral with the first extremity (3) and arranged to evolve between a de-latching configuration, where the means of encircling (5) forms an open collar freeing the second extremity (4), and a latching configuration where the means of encircling (5) forms a closed collar designed to surround the second extremity (4) so as to unite it with the first extremity (3), the closed collar having opposite front (6) and rear (7) faces, between which an encircling opening extends that is designed to accept the second extremity (4).

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 polymeric, surgical clip having first and second curved leg members joined at their proximal end by a hinge portion and movable from an open position to a closed position for securing and maintaining a desired amount of tension on a suture. A ridge protrudes from a portion of the inner surface of one leg and a groove is formed in a corresponding portion of the inner surface of the other leg. An eyelet extends through the ridge to engage a portion of a suture.

Abstract: A forceps of endoscope comprises a clip that is provided with at least three arms and a base end portion. The arms are connected to the base end portion. Each of the arms has an open-close deforming portion located close to the base end portion. A core member is provided inside the clip to be in contact with an inner surface of the open-close deforming portion at least when the arms are open. A clip open-close ring is operated by remote control performed from the base end of the sheath. The clip open-close member is engaged with the open-close deforming portion to open and close the arms with a substantially equivalent angular interval and so as to prevent each of the arms from crossing each other.

Abstract: The present invention features a device to prevent the unwanted flow of urine in incontinent human males. This penile clamp is designed to provide an external pressure applied to the underside of the penis at the base thereof to close the urethral canal. The apparatus includes a rigid projection on the lower member of the device that applies a concentrated force on the canal. The upper bar of the device provides an attachment for a pad as an integral part of an easily disinfected clamp that is hinged at one end and provided with an adjustable tensioning closure device at its other end. The closure device is easily removable to allow one hand release of the penis restriction. A screw-type adjustment is easily set and is easily disassembled by a quick-release apparatus. While the clamp can be closed over the penis of an incontinent male to prevent urination, it does not appreciably restrict blood flow therein.

Abstract: A gastric band implant characterized in that a strap constituted by an elongate piece is secured to the inside of an inflatable bag. The width and thickness of the piece are smaller than the corresponding dimensions of an oblong right cross-section of the bag. The piece possesses convex longitudinal edges and has complementary overlapping connection structures on opposite end portions of the strap.

Abstract: An external incontinence clamp for stopping involuntary voiding of urine is provided. The clamp includes a first rigid member having opposed ends, each end defining a passage extending therethrough, a second rigid member having opposed ends, each end defining a passage extending therethrough, and two pins of generally u-shape. The pins are adapted to be received by the passages defined by the ends of the first rigid member and of the second rigid member so as to secure the first rigid member in a spaced and generally parallel relationship to the second rigid member. The penis is positioned between the first and second members so that the underside of the penis is in contact with the second member and the top surface of the penis is in contact with the first member, thereby stopping involuntary voiding of urine. A clamp kit includes a plurality of pins of different width to vary the force applied to the penis.

Abstract: A tissue connector assembly comprising a clip movable between an open configuration and a closed configuration and a mechanical restraining device including a plurality of strands releasably attachable to the clip for restraining the clip in its open configuration. A needle may be releasably attached to the clip. A flexible member may also interconnect the clip and the needle.

Abstract: This is directed to containers and methods for holding and delivering vaso-occluding materials such as hydrogel particles and filaments. The vaso-occlusive materials may be held in the container in a hydrated or unhydrated state. The container includes a fluid ingress port and a fluid egress port that are respectively fluidly connectable with a fluid source and a delivery catheter. The container further includes at least one chamber or passageway extending therebetween. The passageway may be straight, curved, spiral, helical, narrow or otherwise shaped. The chamber may also have sections of varying cross section such as a ramped section. The shapes of the passageways of the container help organize ejection of the vaso-occluding materials minimizing contamination and clumping. Methods for holding and introducing the materials are also provided.

Abstract: A replaceable pad or insert for attachment to the jaw of a jaw-type occlusion device. The insert includes an elastomeric cushion with a deflecting element embedded in the cushion, providing for improved gripping of a clamped vessel while minimizing trauma to the vessel.

Abstract: This is a device for bridging the neck of either a wide-necked or narrow-necked aneurysm in the vasculature. In general, it is a device used to stabilize the presence of vaso-occlusive devices (such as helically wound coils) in the aneurysm. The device preferably is delivered by a core wire which terminates in an electrolytically severable joint. The core wire will often be insulated. The retainer assembly itself is also attached to the electrolytic joint and typically has a number of array elements which are intended to be resident within the aneurysm after the device is deployed from the distal end of a catheter. After deployment of this retainer, the aneurysm is at least partially filled with a vaso-occlusive device such as helically wound coils.

Abstract: A gastroplasty ring having a single control is provided and includes a flexible strip with two ends for being closed around the stomach by a closure system so as to reduce the diameter of the opening of the stoma. The strip may have an annular compression chamber of adjustable volume and of substantially constant section connected by an adjustment catheter to a device for adjusting the internal pressure in the chamber so as to adjust its diametral expansion. The closure system may be used for reversibly locking and loosening the ring, and for releasing the diameter of the ring momentarily by relative displacement between the two ends, while continuously forming a closed loop around the stomach. The ring constitutes a gastric implant for treating obesity.

Abstract: A surgical staple for use in creating an everted anastomosis of at least two anatomical structures includes a bendable staple body. At least two evening elements protrude from the staple body. Spacing elements and a penetrating element also are provided. In use, the evening elements and spacing elements are apposed, and inner layers of the anatomical structures are held together to form an evened anastomosis. The evening platforms are disposed on an outer radius of the closed staple, and the penetrating element is disposed on a different, inner radius, to ensure that the penetrating element is excluded from the lumen of the anastomosis. Embodiments of the invention substantially ensure intima-to-intima approximation completely circumferentially at the anastomotic site, with no portion of cut tissue edges, suture or staple exposed to the lumen of the anastomosis. Cut tissue edges, as well as the staple, are completely extra-lumenal. Related methods provide similar advantages.

Abstract: A polymeric, surgical clip having first and second curved leg members joined at their proximal end by a hinge portion and movable from an open position to a closed position for clamping a vessel between curved deposing inner surfaces which are substantially parallel when the clip is closed. The first leg terminates at its distal end in a deflectable hook member defining a crest or cutting edge along at least a portion of the outer surface thereof, and the second leg member terminates in a locking portion complimentary to the hook member such that when the first and second leg members are moved from an open position to a closed position about the hinge means the hook member will deflect about the distal end of the second leg member to lock the clip in a closed position.

Abstract: A medical knife assembly includes an outer clamp assembly and an inner clamp blade assembly having a cutting blade assembly. The inner and outer clamp assemblies are pivotally connected at about their proximate ends so they may be squeezed together with one hand to affect a novel method of clamping and cutting in a single motion operation. A set of shear pins holds the component parts of the inner and outer assemblies together in a ready position that enables a user to properly position the knife assembly for severing an umbilical cord at the time of birth. Once the umbilical cord is severed, the component parts of the inner and outer assemblies separate providing independent clamps, one staying with an infant segment of the umbilical cord and one staying with a maternal segment of the umbilical cord.

Abstract: A system and method for delivering a surgical clip to a surgical site within a patient's body to compress body tissue is disclosed. In one embodiment for the system of the present invention, the system includes an endoscopic device that has an endoscope cap disposed on a distal end of the endoscopic device. A surgical clip is removably disposed on an outside surface of the endoscope cap. A deployment device is associated with the surgical clip for deploying the surgical clip from the endoscope cap to the body tissue that is to be compressed.

Abstract: An implantable band for placement around an anatomical passageway, such as the stomach or other lumen, has the inner surfaces at each end attached to each other in the operative position. One end may include a passageway through which the other end extends. A lateral member may extend from the surface at one end and engage the other end.

Abstract: An implantable band for placement around an anatomical passageway, such as the stomach or other lumen, includes a transverse attachment mechanism, such as a dovetail connection or a lateral member disposed in a spiral path.

Abstract: Methods and apparatus for treatment of patent foramen ovale (PFO) generally involve use of a catheter having treatment means at its distal end. In some embodiments, the treatment means includes one or more retractable abrasive needles used to abrade tissue adjacent the PFO to induce closure of the PFO. In other embodiments, treatment means includes an energy transmission member or one or more apertures for dispensing a fluid to contact and close the PFO. An exemplary method involves advancing a catheter device to position the distal end adjacent the PFO, exposing a plurality of abrasive needles from the catheter, advancing the needles through the PFO and/or tissue adjacent the PFO, and retracting the needles relative to the PFO to abrade at least a portion of the tissue.

Abstract: An implantable band for placement around an anatomical passageway, such as the stomach or other lumen, has a non-mechanical attachment mechanism, particularly an adjustable gastric band, includes a hook and loop fastener, magnetic material, adhesive and energy bonded material.

Abstract: An occluder, for use in a body passageway, includes a catheter and a blood flow blocking/tissue capturing element comprising structural members which define openings therebetween. The blocking/capturing element is positioned near the distal end of the catheter. The blocking/capturing element has a radially compressed insertion state and a radially expanded blocking state. The occluder also includes an actuator associated with said catheter to move said blood flow blocking element from said compressed state to said expanded state. The blood flow blocking element may have a generally funnel surface extending out from said distal end of said catheter when the blood flow blocking element is in said radially expanded blocking state. A proximal surface may be provided on the capture element, the proximal surface extending out from the distal end of the elongate tubular member wherein the tissue is captured along the proximal surface.

Abstract: A device for generating an artificial constriction in the gastrointestinal tract comprises a band (1), which can be placed annularly about a particular portion of the gastrointestinal tract, and a closure device (2) for connecting the end regions of the band (1) placed annularly about a portion of the gastrointestinal tract, the band in the closed state of the closure device (2) encompassing a throughlet opening (6), the band (1) including a hollow chamber (13) fillable with a filling medium and extending at least over a large portion of the length of the band (1) and delimited on its side, facing the throughlet opening (6), by a diaphragm (11), by means of which the size of the throughlet opening (6) can be decreased by filling the hollow chamber (13).

Abstract: Inserts configured for attachment to a jaw of a jaw-type occlusion device, such as a surgical clamp or clip, and surgical clamps or clips having such jaw inserts. The inserts include a compliant cushion having a clamping surface adapted for engagement with a vessel or other body tissue, the clamping surface having a plurality of integrally-formed raised patterns extending from the surface to at most 0.010 inches. The raised patterns can be repeating and uniform in nature, or random and non-uniform in nature.

Abstract: A clipping apparatus comprises a clip capable of being arbitrarily opened/closed, a stop tube for closing the clip, a link member capable of being inserted into the stop tube, and engaged with the clip, a sheath section capable of housing the clip and the stop tube therein, and a manipulating wire inserted into the sheath section. This clipping apparatus further comprises a hook section for, when the clip and the stop tube is protruded frontally of the sheath section, causing the sheath section and the stop tube to be engaged with each other, and disabling the stop tube from being housed in the sheath section again.

Abstract: A surgical clamping device for hollow anatomical structures such as, essentially, blood vessels, but also for tracheas, intestines, etc.

Abstract: In a medical clip consisting of a platelet of an elastic bio-compatible material, the platelet is provided with a central H-shaped cut-out so as to form a frame structure with tongues extending from the frame structure toward each other and having adjacent front edges forming grasping elements, and the frame structure is curved and elastically biases the front edges toward each other.

Abstract: A surgical clip with adjustable bias spring. The surgical clip includes a moveable slide assembly, whereby the positioning of the slide relative to the clip adjusts the relative compression or extension of the biasing spring.

Abstract: A releasably locking umbilical cord clamp including one or more of: a gender-identifying color, a grasping portion to facilitate closing and locking the clamp on the remaining umbilical cord, a fluid removal channel, a separable measurement portion to facilitate positioning of the clamp at a suitable location on an umbilical cord, and an operatively associated key to unlock and reposition or remove the clamp. Also included are methods relating to using a gender-identifying color on an umbilical cord clamp to facilitate gender and identity recognition and methods of applying the clamp at the proper distance.

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 redial 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: This document discusses an exovascular approach to treating an aneurysm using a minimally-invasive instrument guided by magnetic resonance imaging (MRI), computed tomography (CT), or another suitable imaging device. A trajectory guide entry device assists in targeting the aneurysm and determining the proper trajectory thereto. Examples of the aneurysm treatment device include a clip, a clasp, a snare, a loop, a hook, a staple, and an electrocautery or other electrode, or any combination of such devices. The aneurysm treatment device is delivered by a probe, such as a tube or other catheter.

Abstract: Devices (plugs) for occluding fallopian tubes are disclosed. The plugs, or at least portions thereof, are made of elastomeric silicone or other biocompatible material and include a pilot hole which permits an insertion device to be used to insert the plug into the fallopian tube. The plugs of the present invention allow fallopian tubes to be rapidly occluded for birth control purposes with minimal adverse side effects. The plugs are also adapted to be removed from the fallopian tubes in a relatively simple procedure without adversely affecting the fallopian tubes.

Abstract: An instrument for clamping and cutting a deformable flexible tube includes handles and jaws pivotally coupled together on opposite sides of a pivot member, a fixed cutting blade on the jaws, integrally hinged lockable V-clamps with ratcheted inner gripping surfaces mounted in the jaws with the edge of the cutting blade positioned above the ratcheted surfaces of the V-clamps, and a device to push the V-clamp axially forward in the jaws. When the handles are pressed together to an intermediate position, the jaws are closed only partially locking the arms of the V-clamps while leaving the edge of the cutting blade distanced from the center of the clamp and from the tube, and when the handles are pressed further to a cutting position, the locked V-clamp is pushed forward in the jaws simultaneously closing the jaws completely and bringing down the cutting blade.

Abstract: An improved surgical clip and clip applicator for placing a surgical clip over a target structure. The surgical clip generally has a pair of opposing clamp arms, each having an associated clamping surface, and a connecting portion joining the clamp arms and biasing them to a normally closed position. The surgical clip may be opened and locked into the open position prior to being loaded into a clip applicator or the surgical clip may be opened by a clip applicator itself. The surgical clip and clip applicators require reduced actuation forces and simplified applicator mechanisms.

Abstract: This invention is a cinch suture having first and second segments and a locking device joining these segments which responds to teeth on the first segment to lock a ligature in place and prevent loosening. The locking device has teeth positioned to interact with engaging elements carried by the first segment as it is passed through the locking device to prevent removal. The locking device teeth are flexible and movable and arranged in two rows in a face to face offset relationship. The first segment engaging elements have a spherical configuration. The first segment passing through the locking device forms an endless loop for encircling and closing an opening formed by surgical excision of an organ or vessel. The locking mechanism has a receiving entrance and a removal exit. The two rows of offset teeth alternately engage spherical engaging elements to provide minute adjustment in the tightness of the suture and place pressure on the suture to hold it firmly in place.

Abstract: Methods and devices for use in tissue approximation and fixation are described herein. The present invention provides, in part, methods and devices for acquiring tissue folds from the anterior and posterior portions of a hollow body organ, e.g., a stomach, positioning the tissue folds for affixing within a fixation zone of the stomach, preferably to create a pouch or partition below the esophagus, and fastening the tissue folds such that a tissue bridge forms excluding the pouch from the greater stomach cavity. The present invention further provides devices for performing a transoral, endoscopic hollow organ division, including a tissue acquisition device capable of acquiring the desired tissue, a tensioning device for positioning the acquired tissue, and a fastening element to secure the outer layers of the acquired tissue such that the desired healing response is achieved.

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 gastric band of a belt type is presented for attaching around a circumference of a patient's stomach, so as to define the diameter of the stomach opening. The band comprises outer and inner surfaces, wherein the inner surface engages the stomach, and at least the outer surface is formed by an elongated member substantially non-extendable along a longitudinal axis thereof. A through-going opening is made in the elongated member and is located so as to define an end portion of the band having a predetermined length. An opposite end portion of the band is shaped so as to be insertable into the through-going opening for adjusting a desired inner diameter of the band in its closed operating position and fastening the opposite end portion to the outer surface of the band.

Abstract: Inserts configured for attachment to a jaw of a jaw-type occlusion device, such as a surgical clamp or clip, and surgical clamps or clips having such jaw inserts. The inserts include a compliant cushion having a clamping surface adapted for engagement with a vessel or other body tissue, the clamping surface having a plurality of integrally-formed raised patterns extending from the surface to at most 0.010 inches. The raised patterns can be repeating and uniform in nature, or random and non-uniform in nature.